2型糖尿病患者记忆功能及相关脑区代谢的改变  

Memory function and metabolic change of related brain regions in patients with type 2 diabetes mellitus

作　　者：李渊灵[1] 王悦[1] 徐晓云[1] 朱雯霞[1] 吕日琅[1] 罗峥[1] 冯波[2] 

机构地区：[1]同济大学附属上海东方医院神经内科,200120 [2]同济大学附属上海东方医院内分泌科,200120

出　　处：《临床神经病学杂志》2013年第3期173-176,共4页Journal of Clinical Neurology

基　　金：上海市浦东新区重点协作项目(PW2008D-7)

摘　　要：目的探讨2型糖尿病患者记忆功能和相关脑区代谢的改变。方法对以记忆减退为主诉的2型糖尿病患者(糖尿病组,73例)和无糖尿病患者(对照组,73例)进行简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)、修订韦氏记忆量表中文版(RWMS-RC)检查。同时予左侧海马、额叶、基底节及丘脑磁共振质子波谱分析检查,采集N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)、肌醇(mI)、肌酸复合物(Cr,Cr2)及谷氨酸复合物(Clx)峰下面积数值,并进行比较。结果 (1)糖尿病组MMSE、MoCA评分,以及MoCA中瞬时记忆及短时记忆评分明显低于对照组(P<0.01～0.005);两组间WMS-RC评分差异无统计学意义。(2)与对照组相比,糖尿病组左侧海马Cr、mI峰下面积及左侧额叶Cr2峰下面积明显高于对照组(P<0.05～0.01);左侧丘脑NAA、Cr2、Cho峰下面积明显低于对照组(均P<0.05)。两组间左侧基底节区各代谢物水平差异无统计学意义。结论 2型糖尿病损害记忆功能;与记忆功能有关的海马、额叶和丘脑存在代谢异常。Objective To investigate the memory function and metabolic change of related brain regions in patients with type 2 diabetes mellitus （T2DM）. Methods The patients complained with hypomnesia including 73 T2DM patients （ DM group） and 73 non-DM patients （ control group） were detected by Mini-mental state examination （MMSE）, Montreal Cognitive Assessment Scale （MoCA） and Revised Wechsler Memory Scale （WMS-RC）. Meanwhile, STEAM1 H-magnetic resonance spectrum （IH-MRS） was performed to scan the left hippocampus, frontal lobes, basal ganglia and thalamus. The peak area values of N-acetylaspartate （ NAA）, creatine and phosphocreatine （ Cr, Cr2）, myoqnositol （ mI）, choline-containing compounds （Cho） and glutamate complex （Glx） were compared between the two groups. Results （ 1 ） Total scores of both MMSE and MoCA and scores for immediate memory and short-term memory in MoCA in DM group were significant lower than the control group （P〈 0. 0143. 005 ）. No significant difference was shown in WMS-RC test between the two groups. （2） The peak areas of Cr and mI in the left hippocampus and Cr2 in the left frontal in DM group were significant higher than those in the control group（P 〈 0. 05- 0.01 ）. Meantime, in the left thalamus, the peak areas of NAA, Cr and Cho in DM group were evidently lower than those in the control group （all P 〈 0. 05 ）. The differences of any metabolic in the left basal ganglia were no significance between two groups. Conclusion T2DM can impair memory function. There are metabolic abnormalities in the hippocampus, frontal and thalamus which are the memory-related brain regions.

关 键 词：2型糖尿病 磁共振质子波谱 记忆功能 

分 类 号：R587.1[医药卫生—内分泌]