中重度OSAHS患者CPAP治疗前后^1H-MRS变化的初步研究  

Preliminary research of ^1H-MRS for moderate and severe OSAHS patients before and after CPAP treatment

作　　者：穆新暖 董鹏飞[1] 姜兴岳[1] 刘新疆[1] 房俊芳[1] 毛宁[2] 王滨[1] 

机构地区：[1]滨州医学院附属医院影像科,山东滨州256600 [2]烟台毓璜顶医院影像科

出　　处：《实用放射学杂志》2016年第3期346-349,共4页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81171303）.

摘　　要：目的用多体素磁共振波谱（^1H-MRS）探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者持续正压通气（CPAP）治疗前后的变化。方法对25例进行CPAP治疗前后的中重度男性OSAHS患者及与其性别、年龄相匹配的25例健康对照者的双侧额叶均行头颅多体素。H-MRS检查。分别记录额叶各代谢物比值，比较两两之间的差异，并观察有无乳酸（Lac）峰出现。结果治疗前额叶NAA／Cr、NAA／Cho（2.0212±0．2312和1．6088±0．2571）较健康对照者（2．7268±0．607l和2．4456±0．4375）减低，治疗后额叶NAA／Cr、NAA／Cho（2．3140±0．3128和2．0164±0．4240）较治疗前（2．0212±0．2312和1．6088±0．2571）升高，治疗后额叶NAA／Cr、NAA／Cho（2．3140±0．3128和2．0164±0．424O）较健康对照者（2．7268_-Z-0．6071和2．4456±0．4375）减低（P〈0．01）。治疗前Cho／Cr（1．2932±0．2615）较健康对照者（1．1292±0．1577）升高（P〈0．05）。3组均未检测到Lac峰。结论多体素^1H-MRS能敏感显示OSAHS患者CPAP治疗前后脑代谢的改变，提供临床疗效及预后评估的影像学依据。Objective To investigate the variation of multivoxel ^1H magnetic resonance spectroscopy（^1H-MRS）before and after continuous positive airway pressure （CPAP） treatment in obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Brain multivoxel ^1H-MRS examinations were performed in 25 cases of moderate or severe OSAHS patients before and after CPAP treat ment,and 25 cases of healthy. The ratios of brain metabolites of the frontal lobe were recorded and analyzed respectively. To observe whether the lactate{Lac） peak appeared or not. Results In the frontal lobe,the NAA/Cr,NAA/Cho of the patients before treatment （2. 021 2±0.231 2 and 1. 608 8±0. 257 1,respectively） was decreased compared with the healthy （2. 726 8±0. 607 1 and 2. 445 6±0. 437 5）. The NAA/Cr,NAA/Cho of the patients after treatment （2. 314 0±0. 312 8 and 2. 016 4±0. 424 0,respectively） was in creased compared with the patients before treatment （2. 021 2±0. 231 2 and 1. 608 8±0. 257 1）. The NAA/Cr,NAA/Cho of the patients after treatment （2. 314 0±0. 312 8 and 2. 016 4±0. 424 0,respectively） was decreased compared with the healthy （2. 726 8±0. 607 1 and 2. 445 6±0. 437 5）, and the differences were statistically significant （P〈0.01）. The Cho/Cr of the patients before treatment （1.293 2±0.261 5） was increased compared with the healthy （1. 129 2±0. 157 7）, the difference was statistically significant（P〈0.05）. Lac peak was not detected in all. Conclusion Muhivoxel ^1H-MRS can demonstrate sensitively the changes of brain metabolism in pa tients with OSAHS before and after CPAP treatment,and may provide imaging evidence for clinical therapeutic effect and prognostic evaluation.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 多体素^1H MRS 脑代谢 持续正压通气 

分 类 号：R56[医药卫生—呼吸系统] R445.2[医药卫生—内科学]