2型糖尿病合并高血压脑损害代谢物改变研究  

Metabolites Alterations of Brain Damage in Type 2 Diabetic Patients Combined with Hypertension

作　　者：林小荣[1] 曹震[2] 何戎 张颖 肖叶玉[2] 

机构地区：[1]汕头大学医学院第二附属医院急诊内科,广东省汕头市515041 [2]汕头大学医学院第二附属医院医学影像科,广东省汕头市515041

出　　处：《中国全科医学》2016年第34期4183-4186,4195,共5页Chinese General Practice

基　　金：国家自然科学基金资助项目(81371612);广东省自然科学基金资助项目(S2013010013867);广东省医学科研项目(A2014446)

摘　　要：目的探讨2型糖尿病合并高血压脑损害代谢物改变情况。方法选取2013年4月—2014年11月汕头大学医学院第二附属医院门诊或住院的2型糖尿病合并高血压患者33例为病例组,及同期与病例组性别、年龄、受教育年限相匹配的健康志愿者30例为对照组。采用美国GE signa HDX-Speed 1.5T超导型磁共振成像仪。二维磁共振频谱(2D-1HMRS)扫描:体素置于半卵圆中心层面,感兴趣区体积为7 cm×10 cm×2 cm,TR 1 500 ms,TE 35 ms。使用SAGE软件分别测定双侧额叶灰质和顶叶白质代谢物比值,包括N-乙酰天冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/Cr。统计学分析采用SPSS 17.0统计软件。结果两组左额叶NAA/Cr、Cho/Cr和右额叶NAA/Cr、Cho/Cr及左顶叶NAA/Cr间差异有统计学意义(P<0.05),而左顶叶Cho/Cr和右顶叶NAA/Cr、Cho/Cr间差异无统计学意义(P>0.05)。其中对照组左额叶与左顶叶(t=0.77,P=0.45)、右额叶与右顶叶(t=-0.81,P=0.43)、左额叶与右额叶(t=-0.66,P=0.51)、左顶叶与右顶叶(t=-0.45,P=0.65)NAA/Cr间差异均无统计学意义;左额叶与左顶叶(t=0.49,P=0.63)、右额叶与右顶叶(t=0.53,P=0.59)、左额叶与右额叶(t=-0.96,P=0.35)、左顶叶与右顶叶(t=-0.79,P=0.93)Cho/Cr间差异亦均无统计学意义。病例组左额叶与左顶叶(t=5.40,P<0.01)、右额叶与右顶叶(t=-5.86,P<0.01)、左额叶与右额叶(t=3.14,P=0.01)、左顶叶与右顶叶(t=2.74,P=0.01)NAA/Cr间差异均有统计学意义;左额叶与左顶叶(t=-0.78,P=0.94)、左额叶与右额叶(t=-0.46,P=0.65)、左顶叶与右顶叶Cho/Cr(t=-0.90,P=0.38)Cho/Cr间差异无统计学意义,而右额叶与右顶叶(t=-2.93,P=0.04)Cho/Cr间差异有统计学意义。结论 2型糖尿病合并高血压导致的脑损害呈进展性,双侧额叶灰质及左侧顶叶白质均发生代谢功能紊乱,代谢物改变以NAA/Cr降低、Cho/Cr升高为主,额叶灰质较顶叶白质明显,左侧较右侧明显。Objective To investigate the metabolites alterations of brain damage in type 2 diabetic patients combined with hypertension. Methods Thirty- three type 2 diabetic patients combined with hypertension,who received treatment in the outpatient of or hospitalized in the Second Affiliated Hospital of Shantou University Medical College from April 2013 to November2014,were selected as the patients group,and 30 healthy volunteers whose gender,age,and educational years were matched with those of the patients group were enrolled as the control group at the same period. The US GE signa HDXT- Speed（ 1. 5T superconducting magnetic resonance imager） was used in the study. The scanning results of two- dimensional H magnetic resonance spectrum was shown as follow,the voxel was located in the semiovale center,the volume of interest was 7 cm × 10 cm× 2 cm,TR 1 500 ms,and TE 35 ms. The SAGE software was used to measure the specific value of bilateral frontal lobe graymatter and left parietal lobe white matter, including N- acetylaspartate（ NAA） / creatine（ Cr） and Choline（ Cho） / Cr.Statistical analysis were performed with SPSS 17. 0. Results There were significant differences in NAA / Cr and Cho / Cr in left frontal lobe and NAA / Cr and Cho / Cr in right frontal lobe and NAA / Cr in the left parietal lobe between the two groups（ P〈0. 05）,while there were no significant differences in Cho/Cr in left parietal lobe and NAA/Cr and Cho/Cr in right parietal lobe（ P〈0. 05）. The NAA / Cr between left frontal lobe and left parietal lobe（ t = 0. 77,P = 0. 45）; between right frontal lobe and right parietal lobe（ t =- 0. 81,P = 0. 43）; between left frontal lobe and right frontal lobe（ t =- 0. 66,P = 0. 51）;between left parietal lobe and right parietal lobe（ t =- 0. 45,P = 0. 65） in the control group was not significantly different; and Cho / Cr between left frontal lobe and left parietal lobe（ t = 0. 49,P = 0. 63）; between right frontal lobe and right parietal lobe（ t= 0. 53,P = 0. 59）; be

关 键 词：糖尿病 2型 高血压 脑损害 代谢物 

分 类 号：R587.1[医药卫生—内分泌] R544.1[医药卫生—内科学]