2型糖尿病中枢神经损伤的1H-MRS研究  

The multi-brain comprehensive study of central nervous system injury in patients with type 2 diabetes by 1H-MRS

作　　者：谭西英[1] 王宇[1] 李欣[1] 郭志勇[1] TAN Xiying;WANG Yu;LI Xin;GUO Zhiyong(The First People's Hospital of Xinxiang/The Affiliated People's Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡市第一人民医院新乡医学院附属人民医院,河南新乡453000

出　　处：《中国实用神经疾病杂志》2020年第21期1866-1871,共6页Chinese Journal of Practical Nervous Diseases

基　　金：2019年度白求恩医学科学研究基金项目(编号:B19173AN)。

摘　　要：目的采用氢质子磁共振波谱分析技术(1H-MRS)测定血糖控制不佳的2型糖尿病患者内囊、丘脑、前额叶白质的生化代谢物的变化,探讨2性糖尿病患者中枢神经损伤的特点。方法选取42例血糖控制不佳的2型糖尿病患者,以40名健康志愿者作为正常对照组,所有入组患者均在入组第2天下午同一时间段完成氢质子磁共振波谱检查,以双侧内囊、丘脑、前额叶为感兴趣脑区,分别检测NAA/Cr值和Cho/Cr值,同日完成双下肢动脉彩超和肌电图检查。结果研究组双侧内囊、双侧丘脑和双侧前额叶白质NAA/Cr值均显著低于对照组,差异有统计学意义(P<0.05);研究组左侧内囊、双侧丘脑和双侧前额叶白质Cho/Cr值均高于对照组,差异有统计学意义(P<0.05);研究组右侧内囊Cho/Cr值与对照组相比差异无统计学意义(P>0.05)。结论血糖控制不佳的2型糖尿病患者可能较早出现中枢神经系统损伤,氢质子波普分析技术有望成为糖尿病中枢神经系统损伤的一种客观检查手段。Objective The hydrogen proton magnetic resonance spectroscopy(1H-MRS)was used to detect the changes of biochemical metabolites in internal capsule,thalamus and prefrontal white matter of type 2 diabetic patients with poor glycemic control,and to explore the characteristics of central nervous system injury in patients with type 2 diabetes.Methods 42 patients with type 2 diabetes who had poor glycemic control were selected,40 healthy volunteers served as the normal control group.All the enrolled patients completed 1H-MRS at the same time in the afternoon of the second day of enrollment.The bilateral internal capsule,thalamus and prefrontal cortex were used as brain regions of interest to detect NAA/Cr and Cho/Cr values.The lower extremity arterial color Doppler ultrasound and electromyography were performed on the same day.Results The NAA/Cr values of bilateral internal capsule,bilateral thalamus and bilateral prefrontal white matter in the study group were significantly lower than those in the control group(P<0.05),and the Cho/Cr values of left internal capsule,bilateral thalamus and bilateral prefrontal white matter in the study group were higher than those in the control group(P<0.05).There was no significant difference in Cho/Cr value between the right internal capsule and the control group(P>0.05).Conclusion Patients with type 2 diabetes who have poor glycemic control may have early central nervous system damage.1H-MRS is expected to be an objective means of detecting central nervous system damage in diabetes.

关 键 词：磁共振波谱分析技术 2型糖尿病 中枢神经损伤 内囊 丘脑 前额叶 

分 类 号：R587.2[医药卫生—内分泌]