腹膜透析患者脑白质病变的初步研究  

White matter lesions in cerebral magnetic resonance images of patients on peritoneal dialysis

作　　者：江柳[1] 朱海滨[2] 董捷[3] 许戎[3] 朱颖[1] 王霄英[1] 许玉峰[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]北京肿瘤医院放射科 [3]北京大学第一医院肾内科

出　　处：《实用放射学杂志》2014年第9期1447-1450,共4页Journal of Practical Radiology

摘　　要：目的 评估腹膜透析患者脑白质病变的患病率及严重程度.方法 选择无明确脑血管疾病病史的38例腹膜透析患者及38例没有肾脏疾病的对照组行头颅常规MR扫描.2名有丰富经验的放射科医师在不知道临床资料的情况下进行独立阅片,按照Manolio量表分别对脑白质病变、脑沟增宽程度、脑室大小进行半定量分级（脑白质病变和脑萎缩的严重程度分为0～9分）,2组评分比较采用非参数秩和检验.结果 2组患者年龄和性别差异均无统计学意义（P=0.639,P=0.818）.腹膜透析组与对照组的脑白质病变评分（1.78±0.74 vs 1.13±0.41）、脑沟增宽程度（2.05±0.61 vs 1.45±0.60）和脑室大小评分（2.05±0.66 vs 1.37±0.54）的差异均有统计学意义（P＜0.001）.结论 脑白质病变和脑萎缩在腹膜透析患者中患病率和严重程度显著高于对照组.Objective To evaluate the prevalence and severity of white matter lesions in peritoneal dialysis patients. Methods Thirty eight peritoneal dialysis patients and 38 controls without kidney diseases underwent brain magnetic resonance imaging, both without history of known eerebrovascular disease. Two radiologists who were blinded to clinical characteristics semiquantitatively graded white matter hyperintensity, sulcal prominence and ventricular size according to Manolio scale （0-9 for white matter disease nd cerebral atrophy）. The scores were analyzed by Mann-Whitney U test between two groups. Results The difference of age and sex of two groups was not statistically significant （P=0. 639, P=0. 818）. In comparison to controls, peritoneal dialysis patients had more severe white matter disease （ 1.78 ± 0.74 vs 1.13 ± 0.41 ） and cerebral atrophy （ sulcal prominence, 2.05±0.61 vs 1.45 ± 0.60; ventricular enlargement, 2.05±0.66 vs 1.37±0.54）, with all differences were statistically significant （P〈0. 001）. Conclu- sion White matter lesions and cerebral atrophy are pervasive within peritoneal dialysis patients, and peritoneal dialysis patients have a higher prevalence and severity compared with controls without kidney disease.

关 键 词：脑白质病变 腹膜透析 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]