基于磁共振波谱技术探讨肾虚对老年人听皮层代谢的影响  

The effects of Kidney-deficiency on auditory cortex metabolism in the elderly： a ^1H-MRS study

作　　者：梁永辉[1] 曾志梅[1] 窦小清[1] 陈十燕[1] 陈自谦[2] 夏加林[2] 陈贤明[1] 

机构地区：[1]南京军区福州总医院耳鼻咽喉-头颈外科,福州350025 [2]南京军区福州总医院医学影像科,福州350025

出　　处：《国际中医中药杂志》2012年第5期401-404,共4页International Journal of Traditional Chinese Medicine

基　　金：基金项目：福建省社会发展重点项目（项目编号：2009Y0041）

摘　　要：目的运用多体素质子磁共振波谱（protonmagneticresonancespectroscopy，^1H-MRS）技术研究肾虚对老年人听皮层代谢的影响。方法从南京军区福州总医院体检人员中选择受试者，分为老年组30例，对照组20例，两组受试者均予以纯音听阈检测和“肾虚”程度评价，再运用^1H-MRS行双侧听皮层检测，在工作站上测量N．乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、乳酸（Lac）及NAA／Cr、Cho／Cr、NAA／Cho、Lac／Cr等比值，进行统计学分析。比较两组间。肾虚程度及上述听皮层代谢相关指标，分析老年人听皮层代谢变化与“肾虚”程度的关系。结果与青年对照组比较，老年组高频听阈、肾虚评分均明显提高，差异有统计学意义（t=6．335、19．558，P〈0．05）；听皮层NAA／Cr下降、Cho／Cr上升，差异无统计学意义（t=1．415、0．927，P〉0．05）；NAA／Cho明显下降，Lac／Cr上升，差异均有统计学意义（t=2．90、44．871，P〈0．05）。老年组听皮层NAA／Cho和肾虚积分呈负相关（r=-0．773，P=0．025）。结论老年人“肾虚”程度与听皮层神经元的丢失和听力减退有一定的相关性，这可能与发生在老年人的听觉障碍有关。Objective To investigate the effects of kidney-deficiency on auditory cortex metabolism in the elderly by using the proton magnetic resonance spectroscopy（IH-MRS）. Methods 50 volunteers , including 20 young subjects and 30 older subjects matched for gender, were measured by pure tone audiometry, ＂kidney-deficiency＂-related test and were executed 3.0 T multi-voxel 1H-MRS tests, The ratios of N-acetylaspartate （NAA）, choline （Cho） and lactate （Lac） to creatine （Cr） were measured and were compared between the two groups. The t-test analysis were used for statistic process. The relationship between auditory cortex metabolism and the symptom of ＂kidney-deficiency＂ was also analyzed. Results The result of ＂kidney-deficiency＂-related test and pure tone audiometry revealed that there was significant difference between the two groups and the older subjects had the more severity ＂kidney-deficiency＂ and high-frequency heating loss （t=6.335, 19.558, P〈0.05）. The NAA/Cho ratio in the auditory cortex in the older group was significantly lower than that in the younger group （t=2.90, P〈0.05）. There were no significant differences between two groups for the ratios of NAA/Cr and Cho/Cr （t= 1.415, 0.927, P〉0.05）. Decrease of the ratio of NAA/Cho in the older group is significantly related with ＂kidney-deficiency＂（r=- 0.773, P= 0.025）. Conclusion ＂kidney-deficiency＂ play a very important role in the hearing loss and reduction of the number of neurons in auditory cortex of older healthy subjects. It suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults.

关 键 词：肾虚 听皮层 磁共振波谱 

分 类 号：R445.2[医药卫生—影像医学与核医学] R256.5[医药卫生—诊断学]