摘要
目的探讨首发青少年双相情感障碍患者脑结构异常及临床相关特征。方法回顾性分析2013年1月至2015年1月首都医科大学附属北京安定医院收治的384例首发青少年双相情感障碍患者的临床资料及头部CT资料,依据头部CT有无异常表现,将患者分为头部CT异常组(n=37)与头部CT正常组(n=347)。观察头部CT异常者的临床特点包括性别、年龄、家族史、母孕期情况、临床表现等,比较头部CT异常和头部CT正常组患者的临床特征,以及头部CT异常的影像学表现。结果首发青少年双相情感障碍脑结构异常者37例,头部CT异常率为9. 6%(37/384),其中脑沟增宽11例(29. 7%),脑室扩大10例(27. 1%),大枕大池7例(18. 9%),透明隔间腔5例(13. 5%);胼胝体发育不良3例(8. 1%);蛛网膜囊肿1例(2. 7%)。与正常者相比,首发青少年双相情感障碍头部CT异常者的母孕期异常(剖宫产、早产者)更常见,年龄更小,差异具有统计学意义(P <0. 01)。采用Pearson相关统计分析发现,首发青少年双相情感障碍患者头部CT异常者,脑结构异常的发生与母孕期异常呈正相关(r=0. 17,P <0. 01);与年龄呈负相关(r=-0. 32,P <0. 01);与性别、临床表现、家族史等无相关性(P> 0. 05)。结论首发青少年双相情感障碍脑结构异常检出率较高,并且脑结构异常者起病年龄更小、母孕期异常更多见,青少年双相情感障碍脑结构异常可能是其神经生物学基础。
Objective To explore the structural brain abnormalities and clinical features in childhood - onset bipolar disorder. Methods Retrospective analysis on clinical features and brain CT images of 384 patients diagnosed as bipolar disorder during January 2013 to January 2015 from Beijing Anding Hospital, Capital Medical University. According to whether there are abnormalities in brain CT images, these patients were divided into 2 groups ; without （ n = 347 ） and with （ n = 37） structural brain abnormalities. Clinical data and socio - demographic features were compared between these two groups. Results The abnormality rate of structural CT scanning was 9.6% （37/384）. There were 11 cases with broadening of cerebral sulci （29.7%） , 10 cases with ventricular dilatation （27.1%） , 7 cases with enlarged cistema magna （ 18.9% ） , 5 cases with carton septum pellucidum （ 13.5% ） , 3 cases with callosal agenesis （8.1% ） , 1 cases with arachnoid cyst （2.7%）. Compared to without structural brain abnormalities, childhood - onset bipolar disorder with structural brain abnormalities had signifiquently younger age, more frequent abnormal maternal pregnancy （ P 〈 0.01 ）. The Pearson correlation analysis showed that childhood - onset bipolar disorder with structural brain abnormalities were negatively correlated with age （ r= -0.32, P 〈 0.01 ） and positively correlated with abnormal maternal pregnancy （ r = 0.17, P 〈 0.01 ）. Conclusion The abnormality rate of structure CT scanning in childhood - onset bipolar disorder is high. The childhood - onset bipolar disorder with structural brain abnormalities exhibit more frequent abnormal maternal pregnancy and younger age. The structural brain abnormalities may play a major role in the neurobiology in childhood - onset bipolar disorder.
作者
潘伟刚
杨春林
应印兵
王文斌
尚宏元
于春祥
PAN Wei-gang;YANG Chun-lin;YING Yin-bing(The National Clinical Research Center for Mental Disorders ＆ Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China)
出处
《临床和实验医学杂志》
2018年第22期2439-2442,共4页
Journal of Clinical and Experimental Medicine
