2型糖尿病患者认知功能及海马氢质子磁共振波谱研究  

The study of cognitive function and proton magnetic resonance spectroscopy on hippocampus in patients with type 2 diabetes mellitus

作　　者：周红[1] 卢万俊[1] 滕皋军[2] 张志珺[1] 吴旻[2] 

机构地区：[1]东南大学附属中大医院神经内科,东南大学脑血管病研究所,江苏南京210009 [2]东南大学附属中大医院放射科,江苏南京210009

出　　处：《中国医学影像技术》2009年第8期1367-1370,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家重点基础研究计划973项目(2007CB512303);国家自然科学基金(30770779)

摘　　要：目的探讨2型糖尿病(T2DM)患者与健康对照者(HC)认知功能与双侧海马代谢的异同。方法应用多维度神经心理测试对比评估21例T2DM患者和19名HC的神经认知功能;并采用氢质子磁共振波谱(1H-MRS)检测双侧海马氮-乙酰天门冬氨酸复合物(NAA),胆碱复合物(Cho)与肌酸(Cr)的比值。结果①T2DM组听觉词语记忆测试-延迟回忆项(AVLT-delayrecall)、听觉词语记忆测试-再认回忆项(AVLT-recognition)和画钟测试(CDT)成绩均显著地低于HC组(P均<0.05),并与糖化血红蛋白(HbA1c)呈负相关;②T2DM患者双侧海马NAA/Cr降低(均P<0.01),并以左侧为著(P<0.05);左侧海马Cho/Cr增高(P<0.05);③双侧海马代谢指标与T2DM患者BMI、FBG和HbA1c呈负相关;左侧海马NAA/Cr与AVLT-DelayRecall成绩正相关。结论T2DM可引起海马代谢异常及多项认知功能损害,且左侧海马代谢异常可能与记忆损害密切相关。Objective To investigate the differences of cognitive function and hippocampal metabolism between patients with type 2 diabetes mellitus （T2DM） and healthy controls （HC）. Methods A total of 21 T2DM patients and 19 HC were enrolled. Multi-dimensional neuropsychological tests were used to evaluate cognitive function, and proton magnetic resonance spectroscopy （1^H-MRS） was applied to explore the metabolic index in hippoeampus. Results （1）Compared with HC, auditory verbal learning test （AVLT）-delay recall, AVLT-recognition and clock drawing test （CDT） in T2DM patients were lower （all P^0.05） and negatively correlated with glycosylated hemoglobin（HbAlc）.（2）QNAA/Cr in bilateral hippoeampus decreased in T2DM patients （P〈0.01） with more obvious impairment in left hippocampus （P〈0. 05） while Cho/Cr of left hippocampus increased （P〈0.05）. （3）Metabolic indexes in bilateral hippocampus of T2DM patients were negatively correlated with BMI, FBG and HbAlc, while NAA/Cr of left hippocampus was positively correlated with the performance of AVLT-delay recall. Conclusion T2DM can cause mutli-cognitive impairment and abnormal hippocampal metabolism, and abnormal metabolism of left hippocampus may closely associate with deficits of memory.

关 键 词：糖尿病 2型 认知 海马 磁共振波谱 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]