合并认知障碍的多系统萎缩患者磁共振氢质子波谱  

~1H-proton magnetic resonance spectroscopy in patients with multiple system atrophy and cognitive dysfunction

作　　者：向小爽[1,2] 侯漩[1] 孙占芳[1] 周高峰[3] 唐北沙[1] 江泓[1] 

机构地区：[1]中南大学湘雅医院神经内科,长沙410008 [2]湘西自治州人民医院神经内科,湖南吉首416000 [3]中南大学湘雅医院放射科,长沙410008

出　　处：《中南大学学报（医学版）》2015年第6期639-645,共7页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81271260;81471156);湖南省自然科学基金(14JJ1008);湖南省科学技术厅一般项目基金(2013FJ3139)~~

摘　　要：目的:应用磁共振氢质子波谱(1H-proton magnetic resonance spectroscopy,1H-MRS)检测合并认知功能障碍的多系统萎缩(multiple system atrophy,MSA)患者双侧额叶的代谢特点。方法:收集23例合并认知功能障碍的MSA患者(研究组1)及19例认知功能正常的MSA患者(研究组2),另选48名与两组MSA患者年龄、性别匹配的正常人(正常对照组)均进行1H-MRS检查,其包括双侧额叶区N-乙酰天门冬氨酸(N-acetylaspartate,NAA)/肌酸(creatine,Cr)、胆碱(choline,Cho)/肌酸(Cr)、肌醇(myoinositol,m I)/肌酸(Cr)的测定。结果:合并认知障碍的MSA患者双侧额叶NAA/Cr值较认知正常的MSA患者和正常对照组显著降低(P<0.05);MSA患者右侧额叶m I/Cr值较正常对照组显著增高(P<0.05);双侧额叶Cho/Cr值3组间差异无统计学意义(P>0.05)。合并认知功能障碍的MSA患者双侧额叶NAA/Cr值与病程呈负相关,与Mo CA评分成正相关。结论:首次在国内应用1H-MRS技术发现额叶NAA/Cr值下降、m I/Cr值增高可能与MSA患者认知功能障碍有关。Objective: To detect metabolic changes of bilateral frontal lobe in patients with multiple system atrophy(MSA) and cognitive dysfunction by 1H-proton magnetic resonance spectroscopy(1H-MRS). Methods: N-acetylaspartate(NAA)/creatine(Cr), choline(Cho)/Cr, myoinositol(m I)/Cr in three sides of frontal lobe were detected by 1H-MRS in 48 healthy controls, 23 patients with MSA and cognitive dysfunction and 19 patients with MSA but without cognitive dysfunction. Results: NAA/Cr of bilateral frontal lobes in patients with MSA and cognitive dysfunction was significantly decreased compared with MSA patients without cognitive dysfunction and healthy controls(P<0.05). m I/Cr of right frontal lobes was significantly increased in patients with MSA and cognitive dysfunction compared with healthy controls(P<0.05). There was a negative correlation between NAA/Cr of bilateral frontal lobes and duration while a positive correlation between NAA/Cr of bilateral frontal lobes and Mo CA score in patients with MSA and cognitive dysfunction. Conclusion: There is a decrease in NAA/Cr and an increase in m I/Cr in frontal lobes in patients with MSA and cognitive dysfunction, which may be associated with cognitive dysfunction in MSA patients.

关 键 词：多系统萎缩 认知障碍 磁共振氢质子波谱 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]