Liu Y, Zeng X Z, Wang Z, Zhang H, Wang X L, Yuan H S
Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
Department of Consultation Liaison, Peking University Sixth Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2019 Apr 18;51(2):260-264. doi: 10.19723/j.issn.1671-167X.2019.02.011.
To evaluate cerebral blood flow (CBF) in patients with comorbid hypertension in depression using 3D pseudocontinuous arterial spin labeling (3D pcASL) and to compare the differences of CBF values in depression, hypertension, and comorbid hypertension between depression and healthy control groups. To investigate the correlation between CBF values and degrees of depression.
Sixteen patients with depression (depression group, 3 males and 13 females, age range of 42-72 years old), sixteen patients with hypertension (hypertension group, 3 males and 13 females, age range of 41-68 years old), sixteen patients with comorbid hypertension in depression (comorbidity group, 3 males and 13 females, age range of 45-74 years old), and sixteen healthy controls (control group, 3 males and 13 females, age range of 43-68 years old) were recruited. 3D pcASL sequence was performed by GE 3.0T magnetic resonance scanner and CBF map was generated automatically. Statistical parametric mapping (SPM8) was performed to preprocess the CBF map, which was spatially normalized and smoothed. Comparison of the CBF values among the four groups was conducted by ANOVA. Correlation between the average CBF values in areas of decreased CBF and Hamilton depression scale (HAMD-17) was investigated.
The patients with comorbid hypertension in depression demonstrated lower CBF in bilateral superior frontal gyri, middle frontal gyri, inferior frontal gyri, right superior parietal gyrus, right inferior parietal gyrus, right supramarginal gyrus, left caudate nucleus and left insula lobe in comparison with the controls. Compared with control group, CBF values decreased in bilateral frontal lobes, but did not reach statistical significance. There were no significant differences of CBF values between the patients with hypertension and control subjects. Compared with depression, the patients with comorbid hypertension in depression showed lower CBF values in bilateral frontal lobes and right supramarginal gyrus. Compared with hypertension, lower CBF values in left middle frontal gyrus in the patients with comorbid hypertension in depression were shown. Correlation analysis indicated that no correlation between CBF values and scores of HAMD-17 was shown.
Although there were no significant decreases of CBF values in patients with depression and hypertension, regional hypoperfusions were observed in patients with comorbid hypertension in depression. Hypertension might play a synergistic action on cerebral hypoperfusion in patients with comorbid hypertension in depression.
采用三维伪连续动脉自旋标记（3D pcASL）技术评估抑郁症合并高血压患者的脑血流量（CBF），并比较抑郁症组、高血压组、抑郁症合并高血压组与健康对照组之间CBF值的差异。探讨CBF值与抑郁程度之间的相关性。
招募16例抑郁症患者（抑郁症组，男3例，女13例，年龄42 - 72岁）、16例高血压患者（高血压组，男3例，女13例，年龄41 - 68岁）、16例抑郁症合并高血压患者（合并症组，男3例，女13例，年龄45 - 74岁）和16例健康对照者（对照组，男3例，女13例，年龄43 - 68岁）。采用GE 3.0T磁共振扫描仪进行3D pcASL序列扫描，并自动生成CBF图。采用统计参数映射（SPM8）对CBF图进行预处理，包括空间归一化和平滑处理。采用方差分析比较四组之间的CBF值。研究CBF值降低区域的平均CBF值与汉密尔顿抑郁量表（HAMD - 17）之间的相关性。
与对照组相比，抑郁症合并高血压患者双侧额上回、额中回、额下回、右侧顶上小叶、右侧顶下小叶、右侧缘上回、左侧尾状核和左侧岛叶的CBF较低。与对照组相比，双侧额叶的CBF值降低，但未达到统计学意义。高血压患者与对照者之间的CBF值无显著差异。与抑郁症患者相比，抑郁症合并高血压患者双侧额叶和右侧缘上回的CBF值较低。与高血压患者相比，抑郁症合并高血压患者左侧额中回的CBF值较低。相关性分析表明，CBF值与HAMD - 17评分之间无相关性。
虽然抑郁症患者和高血压患者的CBF值没有显著降低，但抑郁症合并高血压患者存在局部灌注不足。高血压可能对抑郁症合并高血压患者的脑灌注不足起协同作用。
