动态血压相关脑白质损伤的磁共振弥散张量研究  

Diffusion tensor imaging study on MRI of white matter damage associated with ambulatory blood pressure

作　　者：赵曼丽[1] 郭鹏[1] 兰希福[1] 赵玉璇 

机构地区：[1]潍坊市中医院脑病科,山东潍坊261041

出　　处：《中国实用神经疾病杂志》2018年第3期233-238,共6页Chinese Journal of Practical Nervous Diseases

基　　金：山东省潍坊市卫生和计划生育委员会中医药科研项目计划(2015002)

摘　　要：目的通过磁共振弥散张量成像技术(diffusion tensor imaging,DTI)研究动态血压对高血压患者脑白质的影响,明确脑白质早期损害特点并探讨相关的危险因素。方法选取原发性高血压患者26例为高血压组,选择同期健康体检者19例为对照组,将脑白质部位的各向异性分数(fractional anisotropy,FA)、平均弥散系数(mean diffusion coefficient,MD)与动态血压参数的相关性进行分析。结果与对照组比较,高血压组24hSBP、dSBP、nSBP水平明显升高,差异均有统计学意义(P<0.05);2组24hSBP-CV、dSBP-CV、24hSBP-谷峰值差异有统计学意义(P<0.05)。高血压组非杓型血压节律明显高于对照组,可达38.45%。2组侧脑室前脚、后脚、半卵圆中心FA、MD值差异均有统计学意义(P<0.05),2组侧脑室体部、额叶皮层下白质区域ROI区的DTI参数比较,FA值差异有统计学意义(P<0.05),而颞叶、顶叶、枕叶皮层下白质的FA值、MD值差异均无统计学意义(P>0.05)。结论高血压对脑白质早期损害的部位主要在侧脑室前脚、后脚及半卵圆中心,侧脑室体部及额叶皮层下白质区也存在一定程度的损害。血压水平的升高及血压变异均是导致脑白质早期损伤的因素。Objective By using diffusion tensor imaging （DTI）to study the impact of blood pressure variability on the white matter of hypertensive patients with normal MRI results, to observe the characteristics and relative dangerous factors of early ul- trastructural damage of white matter in hypertensive patients. Methods Selecting 26 cases of patients with primary hypertension as the hypertension group;19 cases of healthy patients as the control group, to analyze the fractional anisotropy（FA）, mean diffu- sion coefficient（M D）of different locations of white matter, and the correlation of FA, MD values with the blood pressures variabili- ty parameters. Results Comparison of the ambulatory blood pressure parameters between the two groups： 24hSBP, dSBP, and nSBP levels of the hypertension group were significantly higher, with statistically significant difference; statistically significant difference was also found between the two groups in 24hSBP-CV, dSBP-CV, valley and peak values of 24hSBP. The non-dipper blood pressure rhythm of the hypertension group up to 38.45 - was significantly higher than that of the control group. Compari- son of the DTI parameters in ROI area at the same locations between the two groups： FA, MD values were significantly different between the two groups in the anterior and posterior horns of the lateral ventricle and the centrum semiovale; Only FA values were significantly different between the two groups in the sbucortex white matter area of the frontal lobe and the body of lateral ventri- cle,while FA, MI） values in subcortex white matter of the temporal lobe, parietal lobe, occipital lobe showed no significant differ- ences between the two groups. Conclusion Early damage caused by hypertension to white matter was mainly found in the anterior horn, posterior horn of lateral ventricle, and the eentrum semiovle. Certain extent of damage was also found in the subcortex white matter area of the frontal lobe and the body of lateral ventricle. Elevated blood pressure,blood pressure v

关 键 词：缺血性脑白质病变 高血压 动态血压 弥散张量成像 FA MD 

分 类 号：R742[医药卫生—神经病学与精神病学]