基于T_2~*值和P_(300)对脑铁含量在阿尔茨海默病认知功能障碍中的研究  

The brain iron contents in Alzheimer's disease with cognitive impairment based on T_2~* value and P_(300)

作　　者：陈浩[1] 宋慧慧 顾卫国 孙岩[1] 张媛 CHEN Hao;SONG Huihui;GU Weiguo(Suzhou Municipal Hospital Affiliated to Nanjing Medical University,Suzhou 215004,China)

机构地区：[1]南京医科大学附属苏州市立医院北区,江苏苏州215004 [2]苏州大学附属广济医院,江苏苏州215137

出　　处：《中风与神经疾病杂志》2018年第11期964-968,共5页Journal of Apoplexy and Nervous Diseases

基　　金：苏州市精神疾病临床医学中心(Szzx201509);苏州市科技局指令性项目(SYS201577)

摘　　要：目的探讨轻度认知损害(MCI)、轻度阿尔茨海默病(AD)患者多个脑区的T_2~*值变化特点,以及与认知事件相关电位P300的相关性,为AD的早期诊断提供参考。方法采用病例对照研究,以2015年1月～2016年12月在苏州市广济医院门诊或住院的22例MCI、24例轻度AD患者为研究对象,选择与患者生活在相同区域、同一时段的25例老年健康者为对照组,对所有受试者行磁共振梯度回波序列扫描获得T_2~*值及事件相关电位P300检查,获得潜伏期N_2、P3和波幅P3。结果 MCI患者海马、黑质T_2~*值较对照组差异有统计学意义(LSD-t=2. 33、2. 06,P均<0. 05);轻度AD患者海马、黑质、内侧颞叶皮质T_2~*值较对照组差异有统计学意义(LSD-t=4. 49、2. 85、2. 62,P均<0. 05); MCI患者海马T_2~*值较AD组差异有统计学意义(LSD-t=2. 04,P <0. 05)。MCI、AD患者较对照组潜伏期N2长(LSD-t=2. 01、4. 93,P均<0. 05),波幅P3短(LSD-t=-2. 17、-7. 13,P均<0. 05); AD患者较MCI患者潜伏期N_2长(LSD-t=2. 79,P <0. 01)、波幅P_3短(LSD-t=-4. 75,P <0. 01)。MCI患者海马T_2~*值与潜伏期N_2呈负相关、波幅P3呈正相关(r=-0. 73、0. 57,P均<0. 05); AD患者内侧颞叶皮质、海马、黑质T_2~*值与潜伏期N_2均呈负相关(r=-0. 84、-0. 82、-0. 48,P均<0. 05; AD患者内侧颞叶皮质、海马、黑质T_2~*值与波幅P3均呈正相关(r=0. 50、0. 41、0. 43,P均<0. 05)。结论 MCI、轻度AD患者存在特征性脑区铁含量异常,且与P_(300)呈明显相关,对其定量测量或可作为AD早期诊断较为客观的影像学指标之一。Objective To investigate the changes of T 2*values in several cerebral regions in mild cognitive impairment(MCI)and mild Alzheimer’s disease(AD)and their relationship with the event-related potential P 300 in order to provide the image evidence for early diagnosis of AD.Methods The case-control study design was adopted in the study.22 patients with MCI,24 patients with mild AD who came from the Suzhou Psychiatric Hospital from January 2015 to December 2016 were recruited as patient group,At the same time,25 age-and gender-matched healthy people were included the control group.GRE sequence were used to obtain T 2*maps,P 300 tests were used to obtain N 2,P 3 latencies and P 3 amplitudes.Results There were significant differences of the T 2*values in the hippocampal and substantia nigra between MCI and health controls(LSD-t=2.33,2.06.P<0.05).There were significant differences of the T 2*values in the hippocampal,substantia nigra and medial temporal cortex between AD and health controls(LSD-t=4.49,2.85,2.62.P<0.05).The difference of the T 2*values in the hippocampal was found between MCI and AD((LSD-t=2.04,P<0.05).MCI and AD patients’N 2 latencies were significantly longer(LSD-t=2.01,4.93.P<0.05)and P 3 amplitudes were significantly lower(LSD-t=-2.17,-7.13.P<0.05)than those of the control group.AD patients’N 2 latencies were significantly longer(LSD-t=2.79,P<0.01)and P 3 amplitudes were significantly lower(LSD-t=-4.75,P<0.01)than patients of the MCI.The T 2*values in the hippocampal of MCI were negatively associated with the N 2 latencies and positively associated with the P 3 amplitudes(r=-0.73,0.57.P<0.05).The T 2*values in the medial temporal cortex,hippocampal and substantia nigra of AD were negatively associated with the N 2 latencies(r=-0.84,-0.82,-0.48.P<0.05)and positively associated with P 3 amplitudes(r=0.50,0.41,0.43.P<0.05).Conclusion The abnormalities of iron deposition are observed in certain brain regions in MCI and mild AD and their relationship with P 300.The quantitative measurement is useful

关 键 词：阿尔茨海默病 认知功能 T2*值 P300 脑铁沉积 

分 类 号：R749.16[医药卫生—神经病学与精神病学]