功能磁共振和ApoE及MTHFR基因在皮质下缺血性小血管病患者早期认知障碍中的相关性研究  

Correlation study between functional magnetic resonance and ApoE and MTHFR genes in early cognitive impairment in the patients with subcortical ischemic small vessel disease

作　　者：邹小冬[1] 张震中[1] 程有根[1] 李中春[1] 王海[1] 胡智伟[1] 

机构地区：[1]浙江省立同德医院神经内科,浙江杭州310012

出　　处：《中国现代医生》2017年第7期19-23,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2015KYB072)

摘　　要：目的分析功能磁共振和Apo E、MTHFR基因在皮质下缺血性小血管病(subcortical ischemic small vessel disease,SSVD)患者早期认知障碍中的相关性,为临床诊断提供参考依据。方法收集我院收治的120例SSVD患者,根据有无认知功能损害分为认知正常组(normal cognitive-SSVD group,NC-SSVD,n=52)和非痴呆认知障碍组(vascular cognitive impairment no dementia-SSVD group,VCIND-SSVD,n=68),均行磁共振血流量扫描(magnetic resonance spectroscopy,MRS)和弥散张量成像(diffusion tensor imaging,DTI)检查,并行蒙特利尔认知评估量表(montreal cognitive assessment,Mo CA)调查,通过PCR扩增-限制性片段长度多态性法(PCR-RFLP)测定Apo E及MTHFR基因多态性,分析MRS、DTI参数与Mo CA评分的相关性。结果 VCIND-SSVD组回忆力、注意力与计算力、延迟回忆、视空间与执行功能力及Mo CA总分均明显低于NC-SSVD组(P<0.05);VCIND-SSVD组胼胝体压部及双侧海马、额叶FA值低于NC-SSVD组,胼胝体压部及双侧海马MD值明显高于NC-SSVD组(P<0.05);VCIND-SSVD组ε3/4+ε4/4、TT基因型和ε4、T等位基因的频率均明显高于NC-SSVD组(P<0.05);VCIND-SSVD组右侧额叶NAA/Cr值明显低于NC-SSVD组,左侧颞叶m I/Cr值明显高于NC-SSVD组(P<0.05);双侧海马、额叶及胼胝体压部FA值、胼胝体压部及双侧海马MD值、右侧额叶NAA/Cr值、左侧颞叶m I/Cr值与Mo CA评分呈显著相关性(P<0.05)。结论 MRS、DTI及Apo E、MTHFR基因多态性与SSVD患者早期认知障碍有密切关系,在SSVD患者认知障碍诊断及评估中具有一定的临床价值。Objective To investigate the correlation between functional magnetic resonance （MR） and ApoE and MTH- FR genes in early cognitive impairment in the patients with subcortical ischemic small vessel disease（SSVD）, and to provide reference for clinical diagnosis. Methods A total of 120 patients with SSVD were collected and divided into the normal cognitive-SSVD group（NC-SSVI）, n=52） and vascular cognitive impairment no dementia-SSVD group （vcIND- SSVD, n=68） according to whether there was cognitive impairment or not. Magnetic resonance spectroscopy （MRS） and diffusion tensor imaging （DTI） were performed in all patients. At the same time, Montreal cognitive assessment （MoCA） was performed. Polymorphisms of ApoE and MTHFR genes were determined by PCR-RFLP. The correlation between MRS, DTI parameters and MoCA score was analyzed. Results The ability of recall, attention and calculation, delayed recall, visual space and executive function and the total score of MoCA in VCIND-SSVD group were significantly lower than those in NC-SSVD group （P〈0.05）; the FA values of splenium of corpus callosum and bilateral hippocampus and frontal lobe in VCIND-SSVD group were lower than those in NC-SSVD group. The MD value of splenium of corpus eallosum and bilateral hippocampus were significantly higher than those in the NC-SSVD group （P〈0.05）; the frequen- cies of e3/4＋e4/4, TT genotype and e4, T alleles in VCIND-SSyD group were significantly higher than those in NC- SSVD group （P〈0.05）; the NAA/Cr value of the right frontal lobe in VCIND-SSVD group was significantly lower than that in NC-SSVD group, and the value of mI/Cr in the left temporal lobe was significantly higher than that in the NC- SSVD group （P〈0.05）; there were significant correlations between the FA values of bilateral hippocampus, frontal lobe and splenium of corpus callosum, the M D values of splenium of corpus callosum and bilateral hippocampal, NAA/Cr value of the right frontal lobe, mI/Cr value of the left tempor

关 键 词：认知功能障碍 皮质下缺血性小血管病 功能磁共振 APOE MTHFR基因多态性 相关性 

分 类 号：R749.1[医药卫生—神经病学与精神病学]