2型糖尿病患者后扣带回区^1H—MRS表现与认知功能障碍的相关性研究  

Brain metabolites of the posterior cingulate cortex in type 2 diabetes mellitus with cognitive dysfunction： a ^1H-MRS study

作　　者：汪洋 沈晶[2] 林琳[2] 张清[2] 伍建林[2] WANG Yang;SHEN Jing;LIN Lin;ZHANG Qing;WU Jianlin(Department of Radiology,Xijing Hospital,the Air Force Military Medical University,Xi＇an 710032,China;Department of Radiology,the Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Dalian Medical University,Dalian 116001,China)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032 [2]大连大学附属中山医院放射科,辽宁大连116001 [3]大连医科大学,辽宁大连116001

出　　处：《实用放射学杂志》2018年第10期1485-1490,共6页Journal of Practical Radiology

基　　金：国家自然科学基金项目（81371526）.

摘　　要：目的 探讨2型糖尿病（T2DM）患者后扣带回区（PCC）氢质子磁共振波谱（1H-MRS）代谢物变化及与认知功能及实验室指标的相关性。方法 通过蒙特利尔认知评估量表（MoCA），收集T2DM伴认知功能障碍（T2DM＋CD）组患者11例、T2DM组患者14例及健康志愿者（HC）17例。对受试者进行神经心理评估并采集相关实验室指标。受试者均行1H-MRS扫描，以PCC作为感兴趣区，读取代谢物指标N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、肌醇（mI）、谷氨酸复合物（Glx）及磷酸肌酸（PCr）的曲线下面积，并与认知功能评分及实验室指标进行相关性研究。结果 （1）3组间空腹血糖（FPG）、MoCA评分差异有统计学意义（P＜0.05）；（2）3组间PCC区Cr、Cho、mI、PCr、Glx、Cr＋PCr、mI/Cr、Glx/Cr差异有统计学意义（P＜0.05）；（3）T2DM患者PCC区Cr与MoCA及听觉词语学习测试（AVLT） 5 min呈显著正相关（r=0.448、0.545，P=0.025、0.044），mI/Cr与MoCA呈显著负相关（r=-0.613，P=0.001）。结论 T2DM患者可出现PCC区多种神经代谢物的异常改变，与CD密切相关；1H-MRS是敏感性半定量检测方法，对T2DM患者脑功能评价具有广阔的临床应用前景。Objective To investigate changes of neural metabolites of the posterior cingulate cortex（PCC） in type 2 diabetes mellitus （T2DM） and correlation with cognitive dysfunction （CD） and lab indexes. Methods Based on Montreal cognitive assessment （MoCA）, 11 patients of T2DM complicated with CD （T2DM＋CD）, 14 patients of T2DM without CD（T2DM）and 17 healthy participants were recruited in this study.Neuropsychological tests were used to evaluate cognitive function.Lab indexes were collected.~ H-MRS was applied to detect neural metabolites. PCC was selected as the region of interest. Neural metabolite indexes such as NAA, Cr, Cho, mI, Glx and PCr were obtained. Correlations between cognitive test scores, lab indexes and metabolite indexes were analyzed.Results （1 ） Fasting plasma glucose and MoCA scores had significant difference between three groups（P〈0.05）. （2） Cr,Cho,mI,PCr,Glx,Cr＋PCr,mI/Cr and Glx/Cr in PCC had significant differences between three groups（P〈0.05）.（3） Cr was positively correlated with MoCA and auditory verbal learning test （ AVLT ） 5 minutes delay recall（ r=0.448,0.545 ,P=0.025,0.044） ,mI/Cr was negatively correlated with MoCA （r=0.613,P=0.001）.Conclusion Various neural metabolites changes abnormally in PCC in T2DM patients, which closely associated with CD.As a sensitive semi-quantitative detection method,ill-MRS has great clinical application in the evaluation of brain function in T2DM patients.

关 键 词：2型糖尿病 后扣带回 磁共振波谱 认知功能障碍 

分 类 号：R587.1[医药卫生—内分泌] R742[医药卫生—内科学]