论文部分内容阅读
近年,国外关于SPECT rCBF显像在精神分裂症、抑郁症和强迫症等精神疾患中的应用已有报道。本期刊出2篇关于精神分裂症的临床研究论文,表明我国学者已开始重视该领域的研究。为使此项工作能在我国更有效地开展,以下几个问题需引起注意。首先,关于精神疾病诊断的标准化。上述2篇论文对精神分裂症的诊断标准不同,影响资料的可比性。最近, 据张明园、朱紫青报告(见《中华医学杂志》1995年第75卷第725页),《中国精神疾病诊断方案与诊断标准》(第二版修订本)已经新成立的中华医学会精神科学学会第一届委员会会议审定通过,于1995年1月正式出版发行。此版本在保留我国传统习惯及特色的同时,吸取了国际标准(ICD-10)和美国标准(DSM-Ⅳ)的长处及优点,既兼顾了稳定性原则,也考虑到与国际标准最终接轨的可能性。建议大家今后试用此诊断标准。其次,要建立年龄、性别及右利手(或左利手)相匹配的正常对照组。例如,~(99m)Tc-HMPAO在健康人脑内某些区域,尤其是左颞叶的分布随年龄而有变异,故在设置正常对照组时应予以注意。再次,rCBF定量或半定量参数的应用国内外均不十分统一。就国内而言,以往沿用的有定量法、双侧对应ROI比值法以及Mayberg法。本期2篇论文也不同。为使国内资料有可比性,采用一种简单易行的半定量rCBF参数法是有必要的,至少对同一种疾病的研究尤为重要。最后值得指出,由于国内目前缺少三探头SPECT仪及单晶体cereSPECT仪,因此,rCBF研究的灵敏度及图像的分辨率受到一定限制。且标准化操作规程和各种介入试验条件的严格掌握与否等对结果均有影响。总之,各个环节均要增强“质量”意识。此外,多巴胺受体显像(~(123)Ⅰ-IBZM,~(123)Ⅰ-Epidepride)在精神分裂症患者及其药物治疗中的应用研究动向亦宜注意。
In recent years, foreign countries on the SPECT rCBF imaging in schizophrenia, depression and obsessive-compulsive disorder and other mental disorders have been reported. This issue of two articles on schizophrenia clinical research papers that show that our country scholars have begun to attach importance to the field of research. In order for this work to be carried out more effectively in our country, the following issues require attention. First, standardize the diagnosis of mental illness. The two papers on the diagnosis of schizophrenia different standards, affecting data comparability. Recently, according to Zhang Mingyuan and Zhu Zijin (see Chinese Medical Journal, Vol. 75, No. 725, 1995), the Diagnostic Schemes and Diagnostic Criteria for Mental Illness in China (Second Edition) have been newly established by the Chinese Medical Association Psychiatry Learn the first session of the Committee approved, in January 1995 formally published. While retaining the traditional habits and characteristics of our country, this version draws on the strengths and advantages of both the International Standard (ICD-10) and the American Standard (DSM-IV), taking into account the principle of stability and taking into account the fact that it is ultimately in line with international standards possibility. Suggest that you try this diagnostic standard in the future. Second, to establish the age, gender and right hand (or left hand) match the normal control group. For example, the distribution of ~ (99m) Tc-HMPAO in some regions of healthy human brain, especially the left temporal lobe, varies with age. Therefore, attention should be paid when setting the normal control group. Again, the application of rCBF quantitative or semi-quantitative parameters are not very uniform at home and abroad. For domestic purposes, there are quantitative methods used in the past, bilateral corresponding ROI ratio method and the Mayberg method. This issue of two papers is also different. In order to make the domestic data comparability, it is necessary to adopt a simple and easy semi-quantitative rCBF parameter method, at least for the same disease is particularly important. Finally, it is worth noting that due to the lack of triple-probe SPECT and single-crystal cereSPECT in China at present, the sensitivity of the rCBF research and the resolution of the image are limited. And standardized operating procedures and a variety of interventional test conditions strictly control whether the results have an impact. In short, all aspects should be enhanced “quality ” awareness. In addition, dopamine receptor imaging (~ (123) I-IBZM, ~ (123) I-Epidepride) in the treatment of schizophrenia patients and their drug research trends should also be noted.