路易体痴呆及阿尔茨海默病患者海马氢质子磁共振波谱研究  

The study of hydrogen proton magnetic resonance spectroscopy of the hippocampus of patients with dementia with Lewy bodies and Alzheimer's disease

作　　者：钟笑梅[1,2] 宁玉萍[1,2] 侯乐[1,2] 施海姗[1,2] 罗新妮[1,2] 陈辛茹[1,2] 张岳峰 郑东[1,2] 谭燕[1,2] 陈建平[1,3] 魏文洲[1,4] 黄癸卯[1,4] 吴华旺[1,4] 刘莎[1,4] 黄建伟[1,4] 

机构地区：[1]广州市脑科医院 [2]广州医学院附属脑科医院神经内科,广州510370 [3]广州医学院附属脑科医院老年精神科 [4]广州医学院附属脑科医院放射科

出　　处：《中国神经精神疾病杂志》2012年第12期729-732,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金(编号:30970902);广州市科技计划项目(编号:2010Y1-C631)

摘　　要：目的研究路易体痴呆(dementia with Lewy bodies,DLB)及阿尔茨海默病(Alzheimer's disease,AD)患者双侧海马氢质子磁共振波谱(hydrogen proton magnetic resonance spectroscopy,1H-MRS)代谢物水平变化特点,探索海马1H-MRS在区分DLB和AD中的意义。方法在3T场强条件下,对14例DLB、14例AD患者及15例正常对照(normal control,NC)双侧海马进行单体素1H-MRS采集,测定海马N-乙酰天门冬氨酸(N-acetylaspartate,NAA)、胆碱(choline,Cho)及肌醇(myo-inositol,mI)与肌酸(creatine,Cr)的比值。结果三组海马1H-MRS测量值比较,左、右侧海马NAA/Cr值差异均有统计学意义(F=5.347,P=0.009;F=5.302,P=0.009)。DLB组左侧海马NAA/Cr值(1.56±0.30)、AD组左侧海马NAA/Cr值(1.51±0.22)均低于NC组(1.84±0.35)(均P<0.05)。DLB组右侧海马NAA/Cr值(1.62±0.27)、AD组右侧海马NAA/Cr值(1.49±0.39)均低于NC组(1.90±0.37)(均P<0.05)。DLB组双侧海马NAA/Cr值略高于AD组,但差异无统计学意义(均P>0.05)。三组间双侧海马mI/Cr值、Cho/Cr值差异无统计学意义(均P>0.05)。结论 DLB、AD患者双侧海马存在神经元功能障碍,其代谢物水平不能有效区分DLB和AD。Objective To investigate the characteristics of hydrogen proton magnetic resonance spectroscopy （1H-MRS） in the bilateral hippocampus in patients with dementia with Lewy bodies （DLB） and Alzheimer＇s disease （AD） and their value in differentiating DLB from AD. Methods The metabolic ratios of N-acetylaspartate/Creatine （NAA/Cr）, Myo-inositol （mI）/Cr and Choline （Cho）/Cr in the bilateral hippocampus were determined by using 1H-MRS in 14 patients with DLB, 14 patients with AD and 15 normal controls. Results The NAA/Cr in the bilat- eral hippocampus of patients with DLB （1.56 ± 0.30/1.62 ± 0.27） and AD （1.51 ±0.22/1.49 ± 0.39） was signifi- cantly lower than that of the NC （1.84 ±0.35/1.90 ± 0.37） （all P 〈 0.05）. However, there was no significant dif- ference in NAA/Cr between DLB and AD groups. There were no significant differences in the ratios of mI/Cr and Cho/Cr among the three groups. Conclusions Patients with DLB and AD have neuronal dysfunction in the bilateral hippocampus. The metabolic changes in the Hippocampus can not effectively differentiate DLB from AD.

关 键 词：路易体痴呆 阿尔茨海默病 海马 氢质子磁共振波谱 

分 类 号：R749.1[医药卫生—神经病学与精神病学]