HIV相关神经认知疾病3.0 T ~1H-MRS大脑代谢物与其神经认知功能损伤的相关性  

The Relationship Between the Metabolite Changes and HAND with Different levels of Neurocognitive Impairment at 3.0 T Proton Magnetic Resonance Spectroscopy

作　　者：高树波 吴光耀[2] 王翔[1] GAO Shubo;WU Guangyao;WANG Xiang(Department of MRI,The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430014,P.R.China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院MRI室,武汉430014 [2]武汉大学中南医院影像科

出　　处：《临床放射学杂志》2018年第10期1619-1623,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81171315)

摘　　要：目的探讨人类免疫缺陷病毒（HIV）相关神经认知疾病（HAND）大脑代谢物变化与神经认知功能损伤的相关性。方法采用3. 0 T超高场强磁共振采集25例正常志愿者（SN）和86例HAND患者左侧额叶白质和壳核的质子单体素波谱,统计代谢物峰下面积积分比值。采用方差分析探讨代谢物变化,Pearson相关性分析探讨其与神经认知功能损伤的关系。结果与SN、ANI、MND比较,HAD左侧额叶白质Glx/Cr显著降低（P=0. 01）,mI/Cr显著升高（P=0. 004）,组间比较SN与HAD、ANI与HAD差异均有显著统计学意义（P值均〈0. 05）。HAD左侧额叶白质NAA/Cr低于SN、ANI、MND,MNDCho/Cr低于SN、ANI、HAD,组间比较差异均无统计学意义。HAD左侧壳核NAA/Cr低于SN、ANI、MND,组间比较差异无统计学意义。SN、ANI、MND、HAD左侧壳核Cho/Cr组间比较差异无统计学意义。HAD左侧壳核mI/Cr、Glx/Cr高于SN、ANI、MND,组间比较均无统计学意义。HAND患者左侧额叶白质Glx/Cr、左侧额叶白质和壳核NAA/Cr与MoCA认知量表评分均呈显著正相关（r值分别为0. 47、0. 31、0. 35,P值分别为0. 0001、0. 007、0. 004）;左侧壳核Cho/Cr与MoCA认知量表评分呈显著负相关（r=-0. 26,P=0. 037）。结论 HAND患者左侧额叶白质低水平的Glx与其神经认知功能损伤有关。Glx水平是评估HAND患者神经认知功能损伤的一项较敏感的指标。Objective To evaluate the relationships between the metabolite changes of the brains and human immunodificiency virus associated neurocognitive disorders（ HAND） with different levels of neurocognitive impairment. Methods25 human immunodificiency virus-seronegative healthy control subjects（ SN） and 86 HAND subjects were evaluated at field strengths of 3. 0 T using single-voxel spectroscopy（ SVS） of left frontal white matter（ LFWM） and putamen（ LP）. The peak area intergral ratios of metabolites were measured. Between-group differences in the metabolite levels were evaluated using analysis of variance（ ANOVA）. Pearson correlation coefficients were used to explore the associations between the metabolite changes and HAND with different levels of neurocognitive impairment. Results LFWM Glx/Cr was significantly lower in HAD compared to SN,ANI and MND（ P = 0. 01）,mI/Cr was significantly higher（ P = 0. 004）. It reached statistic significance of LFWM Glx/Cr and mI/Cr between SN and HAD as well as ANI and HAD（ P values were both less than 0. 05）.LFWM NAA/Cr in HAD was lower compared to SN,ANI and MND; Cho/Cr was lower in MND compared to SN,ANI and HAD; however,they both did not reach statistic significance. LP NAA/Cr was lower in HAD compared to SN,ANI and MND; however,it did not reach statistic significance. There was no significant difference of LP Cho/Cr between groups.LP m I/Cr and Glx/Cr were higher in HAD compared to SN,ANI and MND; however,they did not reach statistic significance. Significant positive correlations were observed between LFWM Glx/Cr,LFWM and LP NAA/Cr with MoCA（ r =0. 47,0. 31,0. 35,respectively; P = 0. 0001,0. 007,0. 004,respectively）. LP Cho/Cr showed negative correlation with MoCA（ r =-0. 26,P = 0. 037）. Conclusion Patients with HAND had lower levels of Glx in LFWM,which was associated with neurocognitive impairment. Glx may be a sensitive indicator of neurocognitive impairment in HAND patients.

关 键 词：HIV相关神经认知疾病 磁共振波谱 谷氨酸/谷氨酰胺 

分 类 号：R445.2[医药卫生—影像医学与核医学] R512.91[医药卫生—诊断学] R749.1[医药卫生—临床医学]