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目的探讨 Graves 病(GD)患者的精神状态、脑血流改变部位及两者之间的关系。方法对21例临床确诊为 GD 的右利手患者行 Zung 抑郁自评量表(SDS)、Zung 焦虑自评量表(SAS)评分及 SPECT 局部脑血流(rCBF)显像,判定 GD 患者抑郁和(或)焦虑程度及 rCBF 改变部位。结果病例组与对照组 SDS、SAS 评分差异有显著性(t 值分别为7.26、5.35,P 均<0.001)。90.5%(19/21例)的 GD 患者有抑郁和(或)焦虑症状,其严重程度与血清 FT_3、FT_4及 TSH 无关。SPECT 显像主要表现为额叶、颞叶、基底节及丘脑的放射性摄取减少,相应区域的 rCBF 降低百分比与 SDS、SAS 评分无关。结论 GD 患者伴随的精神症状较健康人群突出,其 rCBF 的降低多集中在双侧额叶、颞叶、基底节及丘脑。
Objective To investigate the mental status of patients with Graves disease (GD), the location of cerebral blood flow changes and the relationship between the two. Methods SDS, Zung’s self-rating anxiety scale (SAS) and SPECT regional cerebral blood flow (rCBF) imaging were performed in 21 clinically diagnosed right-sided patients with GD, and the prevalence of depression And (or) anxiety and rCBF changes in the site. Results There were significant differences in SDS and SAS scores between the case group and the control group (t = 7.26 and 5.35, respectively, P <0.001). 90.5% (19/21) of GD patients had depression and / or anxiety symptoms, and their severity was not related to serum FT_3, FT_4 and TSH. SPECT imaging mainly showed that frontal lobe, temporal lobe, basal ganglia and thalamus decreased radioactivity uptake. The percentage of rCBF decreased in the corresponding region was not related to SDS and SAS scores. Conclusion The psychiatric symptoms in patients with GD are more prominent than those in healthy people. The decrease of rCBF in patients with GD is mainly concentrated in bilateral frontal lobe, temporal lobe, basal ganglia and thalamus.