部分性继发全身强直-阵挛发作癫痫患者双侧丘脑的氢质子磁共振波谱研究  

~1H-magnetic resonance spectroscopy on bilateral thalamus of patients with secondarily generalized tonic-clonic seizures

作　　者：王明月[1] 李蜀渝[1] 周高峰[2] 廖伟华[2] 李国良[1] 肖波[1] 

机构地区：[1]中南大学湘雅医院神经内科,长沙410008 [2]中南大学湘雅医院放射科,长沙410008

出　　处：《中南大学学报（医学版）》2012年第11期1147-1151,共5页Journal of Central South University ：Medical Science

摘　　要：目的:研究部分性继发全身强直-阵挛发作(secondarilygeneralizedtonic-clonicseizure,SGTCS)癫痫患者双侧丘脑的代谢物变化,探讨部分性SGTCS的发生机制。方法:对30例SGTCS癫痫患者(癫痫组)和30例健康对照者(对照组)进行双侧丘脑氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)检查,测定丘脑N-乙酰天门冬氨酸(N-acetylaspartate,NAA)、胆碱复合物(choline-containingcompounds,Cho)、肌酸和磷酸肌酸(creatineandphosphocreatine,Cr-PCr)、肌醇(myo-inositol,mI)的水平,比较两组间及癫痫组双侧丘脑间的代谢物水平。结果:癫痫组左侧丘脑NAA/Cr-PCr和NAA/(Cr-PCr+Cho)的比值分别为1.7074±0.2214和0.9333±0.2173,明显低于对照组的比值1.8834±0.2093和1.1243±0.2447(P<0.05);癫痫组右侧丘脑NAA/Cr-PCr和NAA/(Cr-PCr+Cho)的比值分别为1.7472±0.2439和0.9165±0.2462,明显低于对照组的比值1.8925±0.2004和1.0941±0.2372(P<0.05)。癫痫组患者双侧丘脑之间的NAA/Cr-PCr,NAA/(Cr-PCr+Cho),Cho/Cr-PCr,mI/Cr-PCr比值差异无统计学意义(P>0.05)。结论:SGTCS癫痫患者双侧丘脑的神经元功能异常,双侧丘脑参与了SGTCS的发生机制。Objective： To examine the changes of metabolites in the bilateral thalamus of patients with secondarily generalized tonic-clonic seizure （SGTCS） and to explore the mechanism of SGTCS. Methods： Thirty patients with SGTCS （epilepsy group） and 30 matched healthy controls （control group） were examined by 1H-magnetic resonance spectroscopy （1H-MRS）. The levels of N-acetyl aspartate （NAA）, choline-containing compounds （Cho）, creatine phosphocreatine （Cr-PCr）, and myo-inositol （mI） of the bilateral thalamus were measured in both the epilepsy group and the control group. The ratios of NAA/Cr-PCr, NAA/（Cr-PCr＋Cho）, Cho/Cr-PCr and mI/Cr-PCr were compared and analyzed in the 2 groups Results： The ratios of NAA/Cr-PCr, and NA_A/（Cr-PCr＋Cho）（1.7074 ＋ 0.2214; 0.9333 ＋ 0.2173） in the left thalamus in the epilepsy group were significantly lower than those in the control group（1.8834＋0.2093; 1.1243＋0.2447） （P〈0.05）. The ratios of NAA/Cr-PCr, and NAA/（Cr- PCr＋Cho） （1.7472＋0.2439; 0.9165＋0.2462） in the right thalamus in the epilepsy group were also significantly lower than those in the control group（l.8925 -＋ 0.2004; 1.0941 ＋ 0.2372）（P〈0.05）. There were no significant differences in the ratios ofNAA/Cr-PCr, NAA/（Cr-PCr＋Cho）, Cho/Cr- PCr, and mI/Cr-PCr between the bilateral thalamis in the epilepsy group （P〉0.05）. Conclusion： There is neuronal dysfunction in the bilateral thalamus in the epilepsy group. Abnormal changes of the bilateral thalamus are involved in the mechanism of SGTCS.

关 键 词：癫痫 氢质子磁共振波谱 丘脑 部分性继发全身强直 阵挛发作 

分 类 号：R742.1[医药卫生—神经病学与精神病学]