皮质下缺血性脑血管病的磁共振波谱研究  

Cerebral Metabolite Levels by Using ^1H-MR Spectroscopy in Subcortical Ischemic Vascular Disease

作　　者：舒敏[1] 章军建[1] 张洪[1] 吴光耀[2] 

机构地区：[1]武汉大学中南医院神经科,武汉430071 [2]武汉大学中南医院放射科,武汉430071

出　　处：《微循环学杂志》2014年第2期18-22,F0003,共6页Chinese Journal of Microcirculation

基　　金：国家自然科学基金项目(30970962)

摘　　要：目的:检测皮质下缺血性脑血管病(SIVD)患者和正常对照组不同脑区脑组织的代谢水平,探讨其与认知功能损害的关系。方法:采用多体素磁共振波谱(1 H-MRS)技术评测SIVD患者(SIVD组,n=32例)和体检健康人(对照组,n=21)额叶及顶叶皮质、白质的代谢物N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr);计算有关比值NAA/Cr、Cho/Cr,分析有无认知功能损害SIVD患者上述比值的变化。结果:(1)SIVD组额叶皮质、白质及顶叶皮质、白质各体素NAA/Cr比值明显低于对照组(P<0.01);(2)SIVD组顶叶皮质及白质的Cho/Cr比值明显高于对照组(P<0.01);(3)SIVD组有认知功能损害患者的额叶皮质和顶叶皮质、白质NAA/Cr比值显著低于无认知功能损害者(P值分别<0.01、<0.01、<0.05),Cho/Cr比值的两者间差异无统计学意义(P>0.05)。结论:SIVD患者脑组织存在NAA/Cr、Cho/Cr比值改变,且额叶皮质和顶叶皮质、白质NAA/Cr的下降与认知损害有关。Objective：To investigate cerebral metabolite levels of patients with subcortical ischemic vascular disease（SIVD）and study the relationship between cerebral metabolic levels and cognitive impairment.Method：We used multiple voxel proton magnetic resonance spectroscopy（^1 H-MRS）to measure the peak value of MRS of N-acetyl aspartate（NAA）,choline（Cho）and creatine（Cr）in the frontal cortex,parietal cortex and white matter of 32SIVD patients and 21controls.Results：（1）For patients with SIVD,NAA/Cr in frontal cortex,white matter of frontal lobe,parietal cortex and white matter of parietal lobe were reduced when compared with those in control group（P〈0.01）.（2）Compared to controls,patients with SIVD had higher Cho/Cr in parietal cortex and white matter of parietal lobe（P〈0.01）,but there was no significant difference of Cho/Cr in frontal cortex and white matter of frontal lobe.（3）Compared to SIVD patients without cognitive impairment,patients with cognitive impairment had decreased NAA/Cr in frontal cortex,parietal cortex and parietal white matter;However,no significant Cho/Cr change was found.Conclusion：These results showed that the presence of altered cerebral metabolite levels among patients with SIVD,and the change of the metabolite levels in frontal and parietal lobes was associated with cognitive impairment.

关 键 词：皮质下缺血性脑血管病 磁共振成像 磁共振波谱 认知障碍 

分 类 号：R743[医药卫生—神经病学与精神病学]