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目的 探讨性别对双相障碍(bipolar disorder, BD)Ⅰ型患者海马和海马旁结构的影响.方法 对133例BDⅠ型患者(男60例)和144名对照(男81名)进行3D T1脑结构MR扫描,采用一般线性模型分析疾病、性别及其交互效应对海马和海马旁皮层体积的影响,将年龄和颅内体积作为混杂变量进行控制.结果 疾病主效应有统计学意义(P＜0.01),与对照组比较,患者组的左海马体积(P=0.044)、右海马体积(P＜0.001)、左海马旁皮层体积(P=0.004)、右海马旁皮层体积(P＜0.001)均减小.性别和疾病对左海马旁皮层体积的交互作用有统计学意义(F=6.534,P=0.044),与男性对照组相比,男性患者组左海马旁皮层体积明显减小(P＜0.001),而女性患者组与女性对照组之间差异无统计学意义(P＞0.05).结论 性别因素可影响BDⅠ型患者左海马旁皮层结构,提示双相障碍影像研究中应重视性别的影响.“,”Objective This study aims to investigate the sex difference in the hippocampus and parahippocampus in patients with bipolar disorder. Methods We acquired T1－weighted structural MRI from 133 bipolar type I patients (60 males) and 144 normal controls (81 males). The General Linear Model was used to examine the relationship between sex and brain volumes of the hippocampus and parahippocampus, with age and intracranial volume as covariates. Results Patients showed significantly smaller volumes of the bilateral hippocampus and parahippocampus (P＜0.01). There were sex－by－diagnosis interactions in the left parahippocampus gyrus (F=6.534, P=0.044). Male patients had significant smaller volumes of the left parahippocampus gyrus compared to the male normal controls (P＜0.001) whereas the volumes were not significantly different between female patients and female normal controls (P＞0.05). Conclusion The results suggest sex difference in the left parahippocampus gyrus volume in patients with bipolar type I disorder, which deserves further investigation in the future bipolar imaging researches.