【摘要】：目的:探討特發(fā)性耳鳴患者情緒中樞興奮性特點,及與耳鳴嚴重程度的相關(guān)性。方法:特發(fā)性耳鳴患者24例和對照組22例進行對照研究,耳鳴患者均行耳鳴匹配頻率檢查,耳鳴殘疾評估量表(THI)、焦慮自評量表(SAS)及抑郁自評量表(SDS)為耳鳴嚴重程度評分。兩組被試均行聲刺激下任務(wù)態(tài)功能性磁共振檢查,刺激強度均為120d B,耳鳴組的刺激頻率分別為耳鳴患者的匹配頻率;對照組的的刺激頻率為1KHz。分別制作眶額皮質(zhì)、杏仁核、前扣帶回的mask,數(shù)據(jù)用spm8軟件進行后處理,獲得激活體積。xjview8.0軟件獲取激活區(qū)圖像。以P0.05為差異具有統(tǒng)計學意義。結(jié)果:1.耳鳴組眶額皮層的激活體積平均值:140.63±122.703,對照組眶額皮層的激活體積平均值:87.00±112.936,兩組比較無差異(Z=-1.826,P㧐0.05);耳鳴組杏仁核的激活體積平均值:7.17±14.708,對照組杏仁核的激活體積平均值:9.27±15.797,兩組比較無差異(Z=-0.688,P㧐0.05);耳鳴組前扣帶回的激活體積平均值:57.87±85.864,對照組前扣帶回的激活體積平均值:36.50±47.073,兩組比較無差異(Z=-0.133,P㧐0.05)。2.耳鳴組眶額皮層的激活體積分別與THI、SAS、SDS的得分行相關(guān)性分析,均無相關(guān)性(rs=0.201,P=0.346;rs=-0.390,P=0.059;rs=-0.242,P=0.255);耳鳴組杏仁核的激活體積分別與THI、SAS、SDS的得分行相關(guān)性分析,均無相關(guān)性(rs=0.372,P=0.073;rs=0.267,P=0.207;rs=0.156,P=0.466);耳鳴組前扣帶回的激活體積分別與THI、SAS、SDS的得分行相關(guān)性分析,均無相關(guān)性(rs=-0.001,P=0.998;rs=-0.345,P=0.099;rs=-0.230,P=0.279)。結(jié)論:1.FMRI可以作為評估耳鳴嚴重程度的客觀檢查方法。2.特發(fā)性耳鳴患者的眶額皮層、前扣帶回的激活體積較正常人的眶額皮層、前扣帶回激活體積大。特發(fā)性耳鳴患者的杏仁核激活體積較正常人激活體積小。3.特發(fā)性耳鳴患者的眶額皮層、前扣帶回和杏仁核激活體積與耳鳴嚴重程度、焦慮及抑郁無關(guān)。
[Abstract]:Objective: to investigate the characteristics of emotional central excitability in patients with idiopathic tinnitus and its correlation with the severity of tinnitus. Methods: 24 cases of idiopathic tinnitus and 22 cases of control group were studied. Tinnitus matching frequency examination and tinnitus disability assessment scale (THI),) were performed in all patients with tinnitus. Self-rating anxiety scale (SAS) and self-rating Depression scale (SDS) were the scores of tinnitus severity. The stimulation intensity was 120 dB, the stimulation frequency of tinnitus group was the matching frequency of tinnitus patients, and the stimulation frequency of control group was 1kHz. The mask, data of orbitofrontal cortex, amygdala and anterior cingulate gyrus were processed with spm8 software to obtain the activation volume. Xjview8.0 software was used to obtain the activation region images. P0.05 as the difference was statistically significant. The result is 1: 1. The average activation volume of orbital frontal cortex was 140.63 鹵122.703 in tinnitus group and 87.00 鹵112.936 in control group. There was no difference between the two groups. The average activation volume of amygdala was 7.17 鹵14.708 in tinnitus group and 9.27 鹵15.797 in control group. The average activated volume of anterior cingulate gyrus was 57.87 鹵85.864 in tinnitus group and 36.50 鹵47.073 in control group. There was no correlation (rs=0.201,P=0.346;rs=-0.390,P=0.059;rs=-0.242,P=0.255) between the activation volume of orbital frontal cortex and the score of THI,SAS,SDS in tinnitus group. There was no correlation (rs=0.372,P=0.073;rs=0.267,P=0.207;rs=0.156,P=0.466) between the activation volume of amygdala and the score of THI,SAS,SDS in tinnitus group. There was no correlation (rs=-0.001,P=0.998;rs=-0.345,P=0.099;rs=-0.230,P=0.279) between the activation volume of anterior cingulate gyrus and the score of THI,SAS,SDS in tinnitus group. Conclusion: 1.FMRI can be used as an objective method to evaluate the severity of tinnitus. 2. The activation volume of orbital frontal cortex and anterior cingulate gyrus in idiopathic tinnitus patients was larger than that in normal subjects. The activation volume of amygdala in patients with idiopathic tinnitus was smaller than that in normal subjects. The activation volume of orbital frontal cortex, anterior cingulate gyrus and amygdala in idiopathic tinnitus patients was not related to the severity of tinnitus, anxiety and depression.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R764.45

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