高血压病合并代谢异常患者脑磁共振波谱及弥散张量成像研究  

Magnetic resonance spectroscopy and diffusion tensor imaging study of patients with hypertension and metabolic abnormality

作　　者：张尤桥[1] 张钦城 容宇[1] 杨忠现[2] 郑晓红[1] 陈薇[1] 

机构地区：[1]广东省汕头大学医学院第二附属医院神经内科,515041 [2]广东省汕头大学医学院第二附属医院影像科,515041

出　　处：《卒中与神经疾病》2014年第1期14-18,共5页Stroke and Nervous Diseases

基　　金：广东省科技厅基金项目(2009B030801042)资助

摘　　要：目的应用磁共振波谱(Magnetic Resonance Spectroscopy,MRS)及磁共振弥散张量成像(Diffusion Tensor Imaging,DTI)检测病程5年以上高血压病患者的脑内代谢物、脑部各向异性(fractional anisotropy,FA)值,以例早期发现亚临床脑细胞损害。方法本研究分为病例组(高血压病12例)及对照组(17例健康体检者),检查一般项目(身高、体重、血压、血糖、血脂、神经功能相关量表评分),行头颅MRI、DWI、MRS、DTI检查,测定脑部背侧丘脑、扣带回后部、侧脑室后角NAA/Cr、Cho/Cr、NAA/Cho的比值及内囊后肢、放射冠区FA值。结果 (1)病例组NAA/Cr在背侧丘脑、扣带回后部、侧脑室后角均低于对照组(分别t=-2.405、-3.710、-2.068,P<0.05);NAA/Cho在扣带回后部、侧脑室后角均低于对照组(分别t=-4.347、3.578,P<0.01);Cho/Cr在扣带回后部高于对照组(t=2.965,P<0.01);(2)FA值在内囊后肢、放射冠区都明显低于对照组(t=-2.543、P<0.05;t=-3.394、P<0.01)。结论高血压病合并代谢异常且病程5年以上者脑细胞代谢功能及神经纤维微结构已有损害,MRS、DTI检测有助于早期发现亚临床脑细胞损害。Objective To early discovered subclinical brain cell damage by using magnetic resonance spectroscopy （MRS） and diffusion tensor imaging （DTI） to detect the metabolic changes and fractional anisot ropy （FA） values in patients with longer than 5 years hypertension. Methods Participants were categorized in to two groups,hypertension group（12 participants）and control group（17 participants）, ranging from 47 to 69 years old. Their body height, weight, blood pressure, blood glucose, blood lipid and nerves function rating scales were measured. We also examined their brain damage by magnetic resonance imaging （MRI）and magnetic reso nance diffusion tensor imaging （DTI）. The metabolite ratios of NAA/Cr, Cho/Cr, and NAA/Cho were meas ured in the posterior cingulate gyrus, dorsal thalamus, and posterior part of lateral ventricle, and FA values were measured in the posterior limb of internal capsule （PLIC）and corona radiate area（CRA）. The data were tested by SPSS 19. 0 software. Results （1）Compared to the control group, significant decreases of NAA/Cr in the dorsal thalamus,the posterior cingulate gyrus and posterior part of lateral ventricle, NAA/Cho in the poste rior cingulate gyrus and posterior part of lateral ventricle, and Cho/Cr in the posterior cingulate gyrus were found（P valiues all-0. 05） in hypertension group. （2）The FA values of the PLIC and CRA in hypertension group were significant decline than control group（P valiue 〈 0. 05）. Conclusions （1）The abnormality of brain cell metabolism and nerve fibre microarchitecture of hypertension group with the course longer than 5 years have existed. （2）MRS and DTI can contribute to understand latent brain damage in the early stage.

关 键 词：高血压病 代谢综合征 磁共振波谱 弥散张量成像 

分 类 号：R544.1[医药卫生—心血管疾病]