重度OSAS患者双侧额叶~1H-MRS改变与抑郁症之间的相关性研究  

Study on the correlation between ~1H-MRS changes of bilateral frontal lobe and depression in patients with severe OSAS

作　　者：赵育英[1] 毛新峰[1] 沈小勇[1] 黄小燕[1] 姚丽娣[1] 陆华东[2] ZHAO Yuyin;MAO Xinfeng;SHEN Xiaoyong;HUANG Xiaoyan;YAO Lidi;LU Huadon(Department of Radiology,Huzhou Central Hospital in Zhejiang Province,Huzhou 313000,China;Department of Respiratory Medicine,Huzhou Central Hospital in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市中心医院放射科,浙江湖州313000 [2]浙江省湖州市中心医院呼吸内科,浙江湖州313000

出　　处：《中国现代医生》2018年第19期113-118,共6页China Modern Doctor

基　　金：浙江省湖州市科技局公益项目(2015GY12);浙江省医药卫生科技计划项目(2014RCA029)

摘　　要：目的探讨重度阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者双侧额叶1H-MRS变化及其与抑郁症之间的相关性。方法采用~1H-MRS成像技术检测56例重度OSAS患者(重度OSAS组)与56名健康对照者(健康对照组)的双侧额叶白质、双侧额叶扣带回N-乙酰天门冬氨酸(N-acetylaspartate,NAA)、胆碱复合物(Choline,Cho)、肌醇(myo-Inositol,mI)和肌酸(Creatine,Cr)的绝对值,并计算NAA/Cr、NAA/Cho、Cho/Cr、m I/Cr的比值。采用汉密顿抑郁量表(Hamilton Depression Scale,HAMD)分别对两组研究对象进行抑郁评分。分析OSAS组中具有统计学意义的1H-MRS参数与HAMD评分之间的相关性。结果重度OSAS组左侧额叶白质NAA/Cho(1.202±0.301)、NAA/Cr(1.727±0.450)及右侧额叶白质NAA/Cho(1.106±0.198)、NAA/Cr(1.652±0.451)均低于健康对照组,差异具有统计学意义(P<0.05);双侧扣带回NAA/Cho分别为(1.163±0.216)、(1.149±0.238)均低于健康对照组,差异具有统计学意义(P<0.05);双侧扣带回Cho/Cr(1.647±0.712,1.646±0.302)、mI/Cr(0.407±0.139、0.472±0.187)均高于健康对照组,差异具有统计学意义(P<0.05)。重度OSAS组HAMD评分为(14.554±9.751)分,明显高于健康对照组,差异有统计学意义(P<0.05)。双侧额叶白质及右侧扣带回NAA/Cho与HAMD评分呈负相关;双侧扣带回Cho/Cr、左侧扣带回m I/Cr与HAMD评分均呈正相关(P<0.01)。结论重度OSAS患者双侧额叶存在异常代谢变化,代谢异常可能是抑郁症发生的病理生理基础。Objective To investigate the changes of 1H-MRS in frontal lobe and its correlation with depression in pa- tients with severe obstructive sleep apnea syndrome（OSAS）. Methods 1H-MRS imaging technology was used to detect N-acetyl-aspartate（NAA）, choline（Cho）, myo-inositol（mI） and creatine（Cr） in the white matter of bilaterial frontal lobes and cingulate gyrus of bilateral frontal lobes in 56 patients with severe OSAS（severe OSAS group） and 56 healthy controls （healthy control group）. The ratios of NAA/Cr, NAA/Cho, Cho/Cr and mI/Cr were calculated. The depression scores of the two groups of subjects were respectively evaluated by Hamilton Depression Scale （HAMD）. The correlation between the statistically significant 1H-MRS parameters and the HAMD scores in the OSAS group was analyzed. Results NAA/ Cho （1.202±0.301） and NAA/Cr （1.727±0.450） of the white matter in the left frontal lobe and NAA/Cho （1.106±0.198） and NAMCr（1.652±0.451） of the white matter in the right frontal lobe in the severe OSAS group were all lower than those in the healthy control group, and the differences were statistically significant（P〈0.05）; The NAA/Cho of bilateral cingulate gyrus was （1.163±0.216） and （1.149±0.238） respectively, which were lower than those in the healthy control group. The difference was statistically significant（P〈0.05）; the ratios of Cho/Cr（1.647±0.712, 1.646±0.302） and mI/Cr （0.407±0.139, 0.472±0.187） in bilateral cingulate gyrus were significantly higher than those in the healthy control group, and the dif- ferences were statistically significant（P〈0.05）. The HAMD score in the severe OSAS group was （14.554±9.751）, which was significantly higher than that in the healthy control group, and the difference was statistically significant（P〈0.05）.NAA/Cho and HAMD score in the white matter of bilateral frontal lobes and right cingulate gyrus were negatively corre lated; the ratio of Cho/Cr in bilateral cingulate gyrus, mI/Cr in

关 键 词：阻塞性睡眠呼吸暂停综合征 波谱成像 磁共振成像 抑郁症 

分 类 号：R766[医药卫生—耳鼻咽喉科]