早期无神经症状的HIV感染者脑代谢和脑血流灌注的MR检测及其与CD4^+T细胞计数的相关性分析  

MR detection of brain metabolism and cerebral blood perfusion in early HIV-infected patients without neurological symptoms and its correlation with CD4^+T cell count

作　　者：王秀娟 颜廷波 WANGXiujuan;YAN Tingbo(Department of Radiology,Xixi Hospital of Hangzhou City,Hangzhou310023,China)

机构地区：[1]杭州市西溪医院放射科,浙江杭州310023

出　　处：《中国现代医生》2020年第22期117-120,F0003,共5页China Modern Doctor

基　　金：浙江省医药卫生科研基金(2018KY626)。

摘　　要：目的通过磁共振(MR)检测患者脑代谢和血流灌注情况,并探讨人类免疫缺陷病毒(HIV)感染者脑代谢、血流灌注与患者CD4^+T细胞计数之间的关系。方法选取2017年7月~2019年7月于我院进行治疗且经过临床确诊的30例获得性免疫缺陷综合征(AIDS)患者和12名志愿者作为研究对象。依据患者和志愿者的CD4^+T细胞计数水平分别为A组(13例)、B组(17例)和对照组。全部受检者行常规MRI及MRS扫描,利用MRS自带的软件完成基线校准和代谢物识别并检测三组的N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌醇(Mi)和谷氨酰胺复合物(Glx6)等脑代谢指标。脑血流灌注情况采用ASL序列分析,通过rCBF图对灌注情况进行定性分析。结果A组的NAA、Cho和Mi的峰面积均显著低于对照组,Glx6显著高于对照组(P<0.05)。B组的Cho峰面积均显著低于对照组,Glx6显著高于对照组(P<0.05)。A组患者的皮质、基底节和丘脑的脑血流低灌注比例显著高于对照组(P<0.05)。A组和B组的NAA、Cho和Mi与CD4^+T淋巴细胞计数呈正相关,而与Glx6呈负相关(P<0.05)。A组的皮质和基底节低血流灌注与CD4^+T淋巴细胞计数呈显著负相关,B组的皮质、基底节和丘脑与CD4^+T淋巴细胞计数呈显著负相关(P<0.05)。结论MR检测技术可以对HIV感染者脑代谢和血流灌注进行有效检测,HIV感染者脑代谢、血流灌注情况与患者CD4^+T细胞计数水平有关。Objective To detect brain metabolism and perfusion in patients with magnetic resonance(MR),and to explore the relationship between brain metabolism,blood perfusion and CD4^+T cells counts in human immunodeficiency virus(HIV)infected patients.Methods Thirty patients with acquired immunodeficiency syndrome(AIDS)who were treated and clinically diagnosed in our hospital and 12 volunteers from July 2017 to July 2019 were enrolled.According to the CD4^+T cell counts of patients and volunteers,they were divided into group A(13 cases),group B(17 cases)and control group.All subjects underwent routine MRI and MRS scans.The software from MRS was used to complete baseline calibration and metabolite identification and detect brain metabolic indicator including N-acetyl aspartate(NAA)and choline(Cho),inositol(Mi)and glutamine complex 6(Glx6).The cerebral blood perfusion was analyzed by ASL sequence analysis,and the perfusion was qualitatively analyzed by rCBF map.Results The peak areas of NAA,Cho and Mi in group A were significantly lower than those in the control group,and Glx6 was significantly higher than that of the control group(P<0.05).The peak area of Cho in group B was significantly lower than that in the control group,and Glx6 was significantly higher than that in the control group(P<0.05).The proportion of cerebral blood flow hypoperfusion in the cortex,basal ganglia and thalamus of group A was significantly higher than that of the control group(P<0.05).NAA,Cho,and Mi in group A and group B were positively correlated with CD4^+T lymphocyte counts,but negatively correlated with Glx6(P<0.05).There was a significant negative correlation between the low blood of the cortex and basal ganglia in group A and the CD4^+T lymphocyte counst.The cortex,basal ganglia and thalamus in group B were significantly negatively correlated with CD4^+T lymphocyte counts(P<0.05).Conclusion MR detection technology can effectively detect brain metabolism and blood perfusion in HIV-infected patients.The brain metabolism and blood perfusion of

关 键 词：HIV感染者 脑代谢 脑血流灌注 MR检测 CD4^+T淋巴细胞计数 

分 类 号：R512.91[医药卫生—内科学] R445.2[医药卫生—临床医学]