FA值与ALS的关系及中西医结合治疗对其的影响  

Correlation between Fractional Anisotropy and Amyotrophic Lateral Sclerosis,and Effect of Integrative Medical Treatment on ALS

作　　者：唐梅丽[1] 杜宝新[2] 陈志远[1] 陈鑫[1] 刘斯润[3] 刘玉品[1] 黄汝杭[1] 刘波[1] 

机构地区：[1]广东省中医院影像科,广州510120 [2]广东省中医院神经四科,广州510120 [3]暨南大学附属第一医院医学影像中心,广州510006

出　　处：《中国中西医结合杂志》2016年第4期421-424,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：广东省科技计划项目(No.2010B080701025)

摘　　要：目的探讨各向异性分数(fractional anisotropy,FA)值是否可作为肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)病情追踪复查的1个量化指标,分析ALS的FA值与中西医结合治疗后的相关性。方法选取18例ALS患者,采用3.0TPropeller HD MR扫描仪对患者进行前后两次弥散张量成像(diffusion tensor imaging,DTI)检查,选取6个感兴趣区,测量FA值;对11例终点事件进行生存分析。结果 (1)大脑脚、内囊后肢、放射冠3个层面兴趣区(region of interest,ROI)按ALS健康状态量表(health status scale of amyotrophic lateral sclerosis,ALS/HSS)分级,轻度者其FA值最高;(2)18例患者的3个层面大脑脚、内囊后肢、放射冠的初查及复查FA均值比较,差异均有统计学意义(P<0.01);(3)Kaplan-Meier生存曲线提示,随着时间的延长,ALS患者的生存率不断下降。中位生存时间为48.0个月。结论 FA值与ALS病情的分级呈反比,病情越重,FA值越低,FA值是判定ALS患者病情的1个客观指标。ALS目前尚为不治之症,中西医结合治疗或许可能是ALS患者治疗的一个方向。Objective To explore whether fractional anisotropy（FA）value could be taken as a quantitative indicator for tracing and reexamining amyotrophic lateral sclerosis（ALS）,and to analyze the correlation between FA value and integrative medical treatment.Methods Totally 18 ALS patients were recruited in this study.All patients received diffusion tensor imaging（DTI）using 3.0T（Propeller HD）MRI twice.Six regions of interest（ROI）were selected to measure FA values.Survival analyses were performed in11 cases of end point events.Results（1）Three ROI（cerebral peduncle,posterior limb of internal capsule,and corona radiata）all indicated that FA value was the highest in patients with mild health status scale of amyotrophic lateral sclerosis（ALS/HSS）.（2）There was statistical difference in the means of FA values in cerebral peduncle,posterior limb of internal capsule,and corona radiata of 18 cases between initial examination and reexamination（P〈0.01）.（3）Kaplan-Meier survival curve showed the survival rate of ALS patients decreased as time went by,with the median survival time of 48 months.Conclusions FA value was inversely proportional to the severity of ALS,the more severe,the lower FA values.FA value was an objective indicator for assessing the severity of ALS.ALS is an incurable disease till now.Integrative medical treatment might become one direction for ALS patients.

关 键 词：肌萎缩侧索硬化症 中西医结合治疗 弥散张量成像 生存分析 

分 类 号：R744.8[医药卫生—神经病学与精神病学]