目的通过抑郁症患者基础和认知激活局部脑血流（ｒＣＢＦ）灌注显像的半定量分析，评估抑郁症患者的脑血流灌注异常。方法选择２７例未经抗抑郁治疗、ＩＣＤ１０分类为中度抑郁发作伴躯体症状的患者，１５例年龄匹配的健康人作正常对照。２７例患者中２１例、１５例健康人中１３例行双日法基础与认知激活脑ｒＣＢＦ显像；另６例患者及２例健康人仅行基础脑ＳＰＥＣＴ显像。认知激活采用Ｗｉｓｃｏｎｓｉｎ卡片分类试验。半定量分析在横断面图像７～１１帧上进行，将各ＲＯＩ的平均计数与同侧小脑的最高计数相除，得到各ＲＯＩ的ｒＣＢＦ比值。结果抑郁症左额叶和左颞叶的基础ｒＣＢＦ值均为０７２０，明显低于对照组（０７６４和０７５０，Ｐ＜００５）；左额、左颞、左顶叶的认知激活ｒＣＢＦ值分别为０７１９、０６９０及０７０１，明显低于对照组（０７８２、０７５２和０７６６，Ｐ＜００１和Ｐ＜００５）。结论①抑郁症患者存在左额叶、左颞叶的局部血流低灌注。②额叶、颞叶皮层低灌注可能是引起抑郁症认知障碍、心境低落的原因。③Ｗｉｓｃｏｎｓｉｎ卡片分类试验认知激活脑ＳＰＥＣＴ显像有助于提高抑郁症的诊断准确性 Objective To evaluate cerebral perfusion abnormalities in patients with depression by semi-quantitative analysis of baseline and cognitively activated partial cerebral blood flow (rCBF) perfusion imaging in patients with depression. Methods 27 cases without antidepressant treatment, ICD 10 classified as moderate depressive episode with somatic symptoms in patients with 15 age-matched healthy subjects as a normal control. Twenty-one of 27 patients and 13 of 15 healthy subjects underwent brain-based rCBF imaging based on double-daily basis and cognitive activation. The other 6 patients and 2 healthy individuals underwent basal brain SPECT imaging only. Cognitive activation using Wisconsin card classification test. Semi-quantitative analysis was performed on 7-11 frames of the cross-sectional image, dividing the average count of each ROI by the highest count of ipsilateral cerebellum, and obtaining the rCBF ratio of each ROI. Results The baseline rCBF values ​​of left frontal lobe and left temporal lobe of depression were 0720, significantly lower than those of the control group (0764 and 0750, P <005). Left frontal lobe, left temporomandibular left parietal lobe Of cognitive activation rCBF values ​​were 0719,0690 and 0701, significantly lower than the control group (0782, 0752 and 0766, P <001 and P <0  05) . Conclusions ①Depression in patients with left frontal lobe, left temporal lobe of local blood flow hypoperfusion. ② Prefrontal and temporal cortical hypoperfusion may be the cause of cognitive impairment and depression in depression. ③ Wiscon-sin card classification test cognitive activation of brain SPECT imaging can help improve the diagnostic accuracy of depression