轻度认知功能障碍患者海马区磁共振波谱研究  

Magnetic resonance spectroscopy of hippocampus in patients with mild cognitive impairment

作　　者：孙永安[1] 何效兵[1] 郭振委[1] 王德华[1] 何明利[1] 

机构地区：[1]徐州医学院附属连云港医院神经内科,江苏连云港222002

出　　处：《实用临床医药杂志》2014年第21期12-16,共5页Journal of Clinical Medicine in Practice

摘　　要：目的分析轻度认知功能障碍(MCI)患者海马结构容积、生化改变与认知功能改变的关系,论证MRS在MCI诊断及病情监测中的价值。方法性别、年龄、文化程度匹配的MCI组和正常对照组各40例,MRI测定左侧海马结构容积前先对每例行MMSE、Mo CA、ADL、CDR、WMS等量表评定,同时测定海马结构N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)和肌醇/肌酸(m I/Cr)值,并对MCI组NAA/Cr、Cho/Cr、m I/Cr、HPF容积与认知功能评分行进行统计分析。结果MCI组NAA/Cr值降低,与NC组相比差异有统计学意义(P<0.01);m I/Cr值增高,与NC组相比差异有统计学意义(P<0.01);2组Cho/Cr值相比无显著差异(P>0.05)。MCI组与NC组相比左侧HPF容积显著减小(P<0.05)。NAA/Cr值与Mo CA、MQ值及左侧HPF容积有显著相关性(P<0.01);Cho/Cr值与MQ值有显著相关性(P<0.05);m I/Cr值与Mo CA值及左侧HPF容积呈显著负相关(P<0.01),m I/Cr值与MQ值呈显著正相关(P<0.01),左侧HPF容积与Mo CA、MQ值亦呈显著相关性(P<0.01)。结论 MCI患者存在海马容积减小、NAA/Cr比值的降低与m I/Cr比值的升高,NAA/Cr、Cho/Cr、m I/Cr、HPF容积与Mo CA、MQ间存在显著相关性。MRS是MCI诊断和病情监测的有用工具。Objective To explore the relationship between cognitive impairment and changes of biochemical metabolites as well as volumes of hippocampus formation （HPF） in patients with mild cognitive impairment （MCI） and evaluate the roles of magnetic resonance spectroscopy （MRS） in the diagnosis and the state monitor of MCI. Methods Before volumes of the left HPF were measured by MRS, mini-mentalstate examination（MMSE）, the Montreal Cognitive Assessment（MoCA）, activities of daily living（ADL）, clinical dementia rating（CDR） and Wechsler memory scale（WMS） were administered in the MCI group （40 MCI patients） and the control group. Meanwhile, the Nacetylaspartate （NAA）/creatine （Cr）, choline （Cho）/Cr, myoinositol （mI）/Cr of HPF were obtained. Moreover, the correlations between the NAA/Cr, Cho/Cr, mI/Cr and the volume of HPF in MCI group were tested. Results In MCI subjects, NAA/Cr reduced （P 〈0.01） and mI/Cr increased （P〈 0.01） in the left HPF. There was no significant difference of the Cho/Cr between the control and MCI groups （P 〉 0.05）. Compared with the control group, the volumes of left t-LPF in the MCI group remarkably decreased. In the MCI group, the NAA/Cr was remarkably correlated with MoCA （P 〈 0.01 ）, MQ （P 〈 0.01 ） and volumes of left HPF（P 〈 0.01）. Cho/Cr was significantly correlated with memory quotient （MQ） （P〈0.05）. mI/Cr had a remarkably negative correlation with MoCA （ r = 0. 708, P 〈 0.01） and volumes of left HPF （P 〈 0.01 ）, but positively correlated with MQ （P 〈 0.01 ）. The volumes of left HPF was remarkably correlated with MoCA （P〈0.01） and MQ （P〈0.01） as well. Conclusion MCI patients have increased mI / Cr ratio , decreased left HPF volumes and NAA / Cr ratio . There are significant correlations between biochemical metabolites of HPF, HPF volumes and MoCA as well as MQ. MRS plays an important role in the diagnosis and the state monitor of MCI.

关 键 词：轻度认知功能障碍 磁共振波谱 海马结构 

分 类 号：R742[医药卫生—神经病学与精神病学]