阻塞性睡眠呼吸暂停综合征的质子磁共振波谱研究  

Study of 1 H-MR spectroscopy in obstructive sleep apnea syndrome

作　　者：杨筠[1] 刘筠[1] 王金月[1] 王荣仁[1] 刘学焕[1] 

机构地区：[1]天津市人民医院医学影像部,天津300121

出　　处：《医学影像学杂志》2008年第9期1006-1009,共4页Journal of Medical Imaging

摘　　要：目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)的质子磁共振波谱(1H-MRS)改变及其临床应用价值。方法:分别对33例OSAS患者和20例健康志愿者行1H-MRS,经多导睡眠仪监测将患者分为轻度OSAS(16例)和中重度OSAS(17例),分别测量脑灰质和脑白质的代谢物包括氮-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)和乳酸(Lac)的波峰下面积,计算NAA/Cho、NAA/Cr、Cho/Cr,对组间代谢物比值的差异进行统计学分析。结果:中重度OSAS患者白质区NAA/Cho(1.56±0.21)低于轻度OSAS患者(1.88±0.23)及正常对照组(1.89±0.25),差异有显著性意义(P<0.01),NAA/Cr轻度降低,Cho/Cr轻度升高,但与轻度OSAS患者和正常对照组比较,无统计学意义(P>0.05)。轻度OSAS患者灰、白质NAA/Cho、NAA/Cr、Cho/Cr与正常对照组之间差异均无显著性意义(P>0.05)。结论:1H-MRS能够早期发现OSAS患者的脑代谢异常,对临床诊断和治疗具有重要价值。Objectlve：Using i H magnetic resonance spectroscopy imaging （^1H-MRSI）to investigate the cerebrai metabolic changes in patients with obstructive sleep apnea syndrome（OSAS）. Methods：^1H-MILS and was perforated in 33 patients with OSAS and 20 control subjects, the patients were classified into two groups based on the results of polysomnography （PSG） ： mild OSAS （ 16 patients） or moderate to severe OSAS （ 17 patients）. Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate to choline （NAA/Cho） as well as to ereatine （NAA/Cr）, and the ratio of choline to ereatine （Cho/Cr） ratios for cerebral cortex and white matter were calculated separately. Results：In the patients with moderate to severe OSAS, the NAA/Cho ratio（ 1.56 ± 0.21 ） for the white Matte was significantly different and lower than that in patients with mild OSAS （1.88±0.23） and healthy subjects（1.89 ±0.25）（ P 〈0.01）. The ratios of NAA/Cr and Cho/Cr had no obvious changes（ P 〉 0.05）. However,no significant difference in the three metabolic ratios was found between patients with mild OSAS and control subjects for cerebral white matter, as well as t/nee groups for cerebral cortex （ P 〉 0.05）. Conclusion：Abnormal cerebral metabohc changes in patients with OSAS could be demonstrated by ^1H-MRSI.

关 键 词：阻塞性睡眠呼吸暂停综合征 脑缺氧 磁共振波谱学 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]