增加铁沉积对脑定量敏感性的映射与阿尔茨海默病中认知功能降低之间关系的研究  

Study on the relationship between the increase of iron deposition on brain quantitative sensitivity and the decrease of cognitive function in Alzheimer's disease

作　　者：金泉伟[1] 杨小梅[1] Jin Quanwei;Yang Xiaomei(Department of Neurology, the Ankang Central Hospital, Shanxi , 725000,China)

机构地区：[1]安康市中心医院神经内科,陕西725000

出　　处：《脑与神经疾病杂志》2019年第10期625-630,共6页Journal of Brain and Nervous Diseases

基　　金：陕西省社会发展科技攻关项目(2016SF-306).

摘　　要：目的 深灰色结构中铁的过度积累是阿尔茨海默病(AD)患者的重要病理特征。定量磁敏度映射(QSM)比其他基于成像的铁测量模式更具有特异性,并且允许非侵入性地评估组织磁化率,已经显示其与脑铁水平良好相关。本研究旨在探讨深部灰质核的磁敏感值(QSM)与轻度和中度AD患者的认知功能之间的相关性。方法 2016年1月至2016年12月于安康市中心医院诊断为轻度和中度AD患者32例作为试验组,并匹配年龄和性别相同的32例健康者作为对照组。用3.0T磁共振成像(MRI)扫描仪扫描。通过QSM定量测量尾状核(Cd),壳核(Pt),苍白球(Gp),丘脑(Th),红核(Rn),黑质(Sn)和齿状物细胞核(Dn)的磁敏感值。结果 本研究提示AD患者双侧Cd和Pt的磁敏感值显著高于对照组(P<0.05)。相比之下,双侧Rn在AD中的磁敏感值(中位值:30.34和32.78ppb×10-9)显著低于对照组(中位值:62.89和70.78ppb×10-9)(P<0.05)。无论性别和年龄如何,左侧Cd的磁敏感值显著增加与智力状态检查量表(MMSE)评分和蒙特利尔认知评估量表(MoCA)评分的降低相关(P<0.05)。结论 本研究证明左尾状核(Cd)的磁敏感值(中位值:57.38ppb×10-9)可能被用作轻度和中度AD患者中疾病严重程度的评估标准。Objective Excessive accumulation of iron in dark gray structures is an important pathological feature in patients with Alzheimer's disease( AD). Quantitative susceptibility map( QSM) is more specific than other imaging-based iron measurement modalities and allows non-invasive assessment of tissue magnetic susceptibility, which has been shown to correlate well with brain iron levels. This study was designed to investigate the correlation between the magnetic susceptibility values of deep gray matter nucleus and cognitive function in patients with mild to moderate Alzheimer's disease( AD). Methods From 2016.01 to 2016.12, 32 patients with mild and moderate AD diagnosed in Ankang Central Hospital were used as the experimental group, and 32 healthy people with the same age and gender were matched as the control group. Scan with a 3.0T magnetic resonance imaging( MRI) scanner. Quantitative measurement of magnetic susceptibility of caudate nucleus( Cd), putamen( Pt), globus pallidus (Gp), thalamus( Th), red nuclei( Rn), substantia nigra( Sn) and dentate nuclei( Dn) by QSM. Results This study suggests that the susceptibility values of bilateral Cd and Pt in AD patients(Median value: 30.34 and 32.78 ppb×10-9) were significantly higher than those in the control group( P< 0.05). In contrast, the susceptibility value of bilateral Rn in AD was significantly lower than that of the control group(Median value: 62.89 and 70.78 ppb×10- 9)( P< 0.05). Regardless of gender and age, the magnetic susceptibility of the left caudate nucleus( Cd) increases significantlyIt was associated with a decrease in the Mental Status Examination Scale( MMSE) score and the Montreal Cognitive Assessment Scale( MoCA) score( P < 0.05). Conclusion Our study suggests that the magnetic susceptibility value of left Cd(Median value: 57.38 ppb × 10-9) may be used as an assessment of disease severity in patients with mild to moderate AD.

关 键 词：阿尔茨海默病 智力状态检查量表 蒙特利尔认知评估量表 认知功能 深部灰质核 

分 类 号：R743[医药卫生—神经病学与精神病学]