术后认知功能障碍的功能磁共振分数低频振幅研究  

Research on Postoperative Cognitive Dysfunction with Fraction Amplitude of Low Frequency Fluctuation Based on Functional Magnetic Resonance Image

作　　者：蔡仁贤[1] 田毅[1] 何占平[2] 候春燕 Cai Renxian;Tian Yi;He Zhanping(Haikou People′s Hospital,Hainan 570208,China)

机构地区：[1]海口市人民医院麻醉科,570208 [2]海口市人民医院影像科,570208

出　　处：《医学研究杂志》2018年第9期115-117,159,共4页Journal of Medical Research

基　　金：海南省科技厅基金资助项目(KJHZ2014-20)

摘　　要：目的在静息态功能磁共振下运用分数低频振幅(fraction amplitude of low frequency fluctuation,fALFF)方法观察老年术后认知功能障碍(postoperative cognitive dysfunction,POCD)患者大脑自发功能活动的变化。方法拟于全身麻醉下择期行腹部手术老年患者50例,ASAⅡ或Ⅲ级,术前1天和术后2周进行认知功能评估,根据是否发生POCD分为POCD组与C组。均于术后2周行功能磁共振扫描,分析比较两组患者的fALFF值。结果与C组比较,POCD组患者楔前叶、后扣带回、左侧岛叶、左侧海马、侧额中回以及左侧颞中回fALFF值显著降低,而在舌回和枕中回区域fALFF值显著增高(P <0. 05,Alpha Sim校正)。结论静息态下多个脑区的自发活动异常可能是POCD发生、发展的重要机制之一。Objective To investigate the alteration of spontaneous functional activity in elderly patients using fALFF based on functional magnetic resonance image （fMRI）. Methods Fifty cases of elderly patients, ASA Ⅱ or Ⅲ, scheduled for elective abdominal surgery under general anesthesia were selected. Patients were assigned into POCD and control group according to the result of cognitive function assessment implemented at the day before and 2 weeks after surgery. All patients were scanned and the fALFF was compared between two groups. Results As compared to control group, the fALFF in precuneus, posterior cingulate cortices, left insula cortex, left hippocampus, middle frontal gyrus and left middle temporal gyrus were decreased, and the fALFF in lingual gyrus and middle occipital gyrus were increased in POCD group （ P 〈0.05, AlphaSim corrected）. Conclusion Abnormality of spontaneous activities in multiple brain regions is the critical mechanism underlying the genesis and development of POCD.

关 键 词：术后认知功能障碍 静息态功能磁共振 分数低频振幅 老年患者 

分 类 号：R614.2[医药卫生—麻醉学]