基于MRS对HIV-1感染者早期脑损伤能量代谢研究  

MRS-Based Research on the Energy Metabolism of Early Brain Injury in Patients with Non-Cognition Disorder HIV Infection

作　　者：齐石[1] 左盼利 员达[1] 赵晶[1] 米海峰[1] 张岩岩[1] 柳娇娇[1] 李云芳[1] 李宏军[1] 

机构地区：[1]首都医科大学附属北京佑安医院放射科,100069 [2]西门子(中国)有限公司医疗业务领域磁共振事业部

出　　处：《临床放射学杂志》2014年第12期1818-1821,共4页Journal of Clinical Radiology

基　　金：北京市自然科学基金项目(编号:7132108);首都医学科技攻关发展项目(编号:2011-2018-01)

摘　　要：目的利用单体素MRS探讨无认知功能障碍症状HIV感染者与正常志愿者间不同脑区N-乙酰天冬氨酸(NAA)、胆碱(Cho)及肌酸(Cr)代谢物质的差异。方法采用3.0 T MR扫描仪对CD4细胞计数≥200 cells/μL(22例,A组)、<200 cells/μL(27例,B组)无认知功能障碍的HIV阳性患者及正常志愿者33名(C组)行单体素MRS检查,分别测量基底节区、额叶白质、顶叶白质区域,比较NAA/Cr与Cho/Cr组间差异。结果 A组、B组与C组比较在基底节区NAA/Cr差异具有统计学意义[P=0.011(A组与C组)和P<0.001(B组与C组)]。在额叶白质A组与B组、C组比较NAA/Cr值升高[P=0.002(A组与B组)和P=0.017(A组与C组)]。A组与C组比较Cho/Cr在基底节区与额叶白质区域显示升高(P=0.023和<0.001)。结论 MRS能够检测出无认知障碍症状HIV感染者在脑基底节区域及额叶白质区域存在代谢异常。Objective To analyze the difference in brain metabolites, including NAA, Cho and Cr, between non-cognition disorder HIV-positive patients and HIV-negative volunteers by using single voxel magnetic resonance spectroscopy （MRS）. Methods A total of 22 patients with CD4^＋ T Lymphocyte counts ≥ 200 cells/μL （group A）, 27 non-cognition disorder HIV-positive patients with CD4^＋ T Lymphocyte counts 〈 200 cells/μL （group B） , and 33 HIV-negative healthy volunteers （ group C） were enrolled in this study. Single voxel MRS examination with a 3.0T MR scanner was performed in all subjects. The concentrations of N-acetyl aspartate （NAA） , Choline （Cho） and Creatine （Cr） at the basal ganglia, frontal white matter and parietal white matter were separately measured. The results were analyzed and compared among three groups. Results Compared to group C, the concentrations of NAA and Cr at the basal ganglia in group A and B were significantly decreased [ P （ A - C ） = 0.011 and P （ B - C） 〈 0. 007 ]. Compared to group B and group C, the concentrations of NAA and Cr at the frontal white matter in group A were slightly increased [P（A - B） =0. 002 and P（A - C） = 0. 017 ]. The concentrations of Cho and Cr at the basal ganglia and the frontal white matter in group A were higher than those in group C （P = 0.023 and P 〈 0. 001 ）. Conclusion The results of this study indicate that MRS can detect the abnormal metabolism at the basal ganglia and frontal white matter in non-cognition disorder HIV-positive patients.

关 键 词：HIV感染 磁共振波谱 认知障碍 N-乙酰天冬氨酸 胆碱 

分 类 号：R512.91[医药卫生—内科学]