磁共振氢质子波谱检查慢性阻塞性肺疾病患者大脑能量代谢异常的临床意义  

Detection of brain energy metabolism changes by proton magnetic resonance spectroscopy in patients with chronic obstructive pulmonary disease

作　　者：文文[1] 孙兵[1] 柳德灵[1] 叶嘉[1] 赖国祥[1] 

机构地区：[1]南京军区福州总医院呼吸与危重症医学科,福州350025

出　　处：《中华老年医学杂志》2012年第8期683-685,共3页Chinese Journal of Geriatrics

基　　金：福建省科技计划重点项目（2009Y0038）

摘　　要：目的通过磁共振氢质子波谱检查（1HMRs）研究慢性阻塞性肺疾病急性加重期（AEc0PD）患者大脑能量代谢物质的改变及与患者氧分压（PaO7）／-氧化碳分压（PaCO2）的关系。方法将13例AECOPD患者及年龄匹配的10例健康对照组行1HMRS检查，测定大脑顶-颞部和枕部的N-乙酰基天门冬氨酸（NAA）／肌酸复合物（Cr）、胆碱复合物（Cho）／Or、肌醇（MI）／Cr的比值，并行血气分析测定患者PaOz和PaCOz，研究大脑能量代谢物质的改变与患者PaOz和PaCOz是否具有相关性。结果AECOPD组顶-颞部及枕部NAA／Cr（1．32士0．12／1．48±0．12）均低于健康对照组（1．45±0．11／1．58±0．10）（P〈0．05，）MI／Cr（0．23±0．07／0．30±0．11）均低于健康对照组（0．40±0．14／0．46±0．12）（P〈O．01），AECOPD组顶-颞部及枕部Cho／Cr与健康对照组差异无统计学意义（P〉0．05）。顶-颞部及枕部NAA／Cr与Pa02呈正相关（r=0．46，0．44），顶-颞部及枕部MI／Or与Pa02呈正相关（r=0．63，0．50），顶-颞部MI／Cr与PaCO。呈负相关（r=0．47）。结论AECOPD患者可出现大脑代谢物质的改变，且和缺氧及二氧化碳潴留有一定的相关性。Objective To study the cerebral energy metabolism changes of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） through hydrogen magnetic resonance spectroscopy examination （1HMRS ） and its relationship with partial pressure of oxygen / carbon dioxide tension. Methods Totally 13 cases of AECOPD patients and 10 cases of age-matched healthy people underwent HMRS examination. The ratios of n-acetyl-aspartate（NAA）/creatine（Cr）, choline （Cho）/ Cr, myo-inositol（MI）/Cr of parieto-temporal and occipital areas of brain were detected. Blood gas analysis were also used to detect partial pressure of oxygen （PaO2） and carbon dioxide （PaCO2）. Results NAA / Cr of parieto -temporal and occipital areas of brain （1.32±0.12, 1. 48±0.12） were lower in AECOPD group than those in control group （1.45±0.11,1.58±0.10） （P〈 0.05）, MI/Cr （0.23±0.07, 0.30±0.11） were also decreased compared with control group （0.40±0.14, 0.46± 0.12） （P〈 0.01）, while Cho/Cr of parieto -temporal and occipital areas of brain between the AECOPD group and control group showed no significant difference （P〈0. 05）. NAA/Cr of parietotemporal and occipital areas of brain were positively correlated with Pa02 （r= 0. 46 and 0. 44）, and MI/Cr of these areas of brain were also positively related with PaO2 （r=0. 63 and 0. 50）, but MI / Cr of parieto tempora was negatively correlated with PaCO2 （r =-0. 472）. Conclusions Cerebral metabolite changes may occur in AECOPD patients, and this has relationship with hypoxia and carbon dioxide retention.

关 键 词：磁共振波谱学 肺疾病 慢性阻塞性 能量代谢 脑 

分 类 号：R445.2[医药卫生—影像医学与核医学]