慢性阻塞性肺疾病患者脑灰质密度变化的初步研究  

Preliminary study of grey matter density changes in patients with chronic obstructive pulmonary disease

作　　者：王小川[1] 张海燕[2] 张家兴[2] 

机构地区：[1]杭州师范大学附属医院神经内科,310015 [2]厦门大学医学院生理学教研室,361005

出　　处：《中华危重症医学杂志（电子版）》2011年第4期12-15,共4页Chinese Journal of Critical Care Medicine:Electronic Edition

基　　金：杭州市科技局(20090833B10);浙江省卫生厅(2009A168);国家自然科学基金(81171324)

摘　　要：目的利用基于体素的形态测量学(VBM)方法,分析慢性阻塞性肺疾病(COPD)患者脑灰质密度与健康人的差异。方法选取COPD患者18例为COPD组和民族、年龄、性别和教育程度相匹配的16例健康体检者为对照组。比较两组间心肺功能、血气分析指标及日常生活能力(ADL)评分。磁共振成像(MRI)行全脑扫描,运用VBM分析影像数据,比较两组被试脑区灰质密度改变。结果 COPD组1秒最大呼气量、用力肺活量及二者的比值、脉血氧饱和度、血氧分压、及ADL评分明显低于对照组,而脉搏次数及二氧化碳分压均明显高于对照组(P均<0.05)。VBM结果显示,与对照组相比,COPD组的右脑(舌回、中央后回、颞上回、海马旁回、海马、杏仁复合体和扣带前回),左脑(颞下回、颞中回和尾状核),双侧岛叶和双侧丘脑灰质密度均显著降低(P均<0.001)。结论 COPD患者慢性缺氧导致了局部脑灰质密度的降低。局部脑区的损害可能参与了COPD患者病理性心肺功能的调节,并可能与其认知和情绪改变有关。Objective To investigate the changes of grey matter density in brain in patients with chronic obstructive pulmonary disease （COPD） by using voxel-based morphometry （VBM）. Methods We selected 18 COPD patients as COPD group and 16 matched healthy volunteers as controls. The cardiopulmonary function, blood gas analysis index and activities of daily living （ADL） score were recorded and compared between the two groups. Each participant received whole brain scans using magnetic resonance imaging. The difference in grey matter volume between patients and controls was analyzed by VBM. Results The forced expired volume in one second （FEV1）, forced vital capacity （FVC）, FEV1/FVC ratio, arterial oxygen saturation, partial pressure of oxygen and ADL score were significantly lower, while pulse was faster and partial pressure of CO2 was higher than the control group （all P〈0.05）. VBM revealed decreased grey matter densities in the COPD group including the right hemisphere （lingual gyms, postcentral cortex, superior temporal gyms, parahippocampus, hippoeampus, amygdala, and anterior cingulate gyrus）, left hemisphere （inferior and middle temporal gyri and caudate）, bilateral insula, and bilateral thalamus） as compared with the controls （all P〈0.001）. Concltmions Chronic anoxia occurred in patients with COPD might induce the reduction of grey matter densities. Regional grey matter impairment might regulate the pathological cardiopulmonary function, and might related to the cognitive and emotional changes.

关 键 词：肺疾病 慢性阻塞性 磁共振成像 灰质 基于体素的形态测量学 

分 类 号：R563.9[医药卫生—呼吸系统]