终末期肾病患者血液透析间期大脑局部一致性异常的静息态功能磁共振成像研究  

The interdialysis abnormal brain regional homogeneity in end-stage renal disease patients:a resting-state functional MRI study

作　　者：李朋[1,2] 马雪英 丁墩[3] 麻少辉 刘继欣[4] 张明 LI Peng;MA Xueying;DING Dun;MA Shaohui;LIU Jixin;ZHANG Ming(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Medical Imaging,No.215 Hopsital of Shaanxi Nuclear Industry,Xianyang,Shaanxi Province 71200,China;Department of Medical Imaging,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Center for Brain Imaging,School of Life Science and Technology,Xidian Unirversity,Xi'an 710126,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]陕西省核工业二一五医院医学影像科,陕西咸阳712000 [3]西安交通大学第二附属医院医学影像科,陕西西安710004 [4]西安电子科技大学生命科学技术学院脑影像研究中心,陕西西安710126

出　　处：《实用放射学杂志》2020年第12期1891-1894,共4页Journal of Practical Radiology

基　　金：国家自然科学基金面上项目(8207071288);陕西省自然科学基础研究计划重大基础研究项目(S2017-ZRJJ-ZDXM-0058);陕西省科技攻关计划项目(2019SF-209)。

摘　　要：目的探讨血液透析间期终末期肾病(ESRD)患者大脑自发神经活动一致性异常.方法对80例ESRD患者(ESRD组)和80例性别、年龄相匹配的健康志愿者(对照组)行rs-fMRI扫描及局部一致性(ReHo)分析;所有ESRD组患者均在血液透析间期行蒙特利尔认知量表(MoCA)评估认知功能,同时间点采集ESRD组实验室指标:血肌酐、尿素、胱抑素C、血红蛋白、甲状旁腺激素;对照组在同时间点进行MoCA评估;计算2组大脑ReHo改变,并进行统计学分析.结果ESRD组及对照组MoCA得分无显著统计学意义(P=0.510);与对照组比较,ESRD组左侧额中回、双侧中扣带、双侧前扣带、左侧海马ReHo值减低(P<0.05,AlphaSim多重比较校正),右侧海马及右侧颞下回ReHo值增高(P<0.05,AlphaSim多重比较校正),组间差异脑区ReHo值与ESRD组实验室指标的相关性均无显著统计学意义(P值均>0.05).结论ESRD患者血液透析间期整体认知水平正常,存在多区域自发神经活动一致性异常,这种异常对揭示透析治疗对ESRD患者认知损伤评估提供客观影像学依据.Objective To investigate spontaneous neural activity abnormalities in patients with end-stage renal disease(ESRD)at interdialysis.Methods 80 ESRD patients(ESRD group)and 80 healthy volunteers(control group)who were matched by gender and age were performed on rs-fMRI scans and ReHo analysis.All the patients in the ESRD group were evaluated by the Montreal cognitive assessment(MoCA)at interdialysis.The laboratory indicators of the ESRD group were collected at the same time point,including serum creatinine,urea,cystatin C,hemoglobin and parathyroid hormone.The MoCA were evaluated in the control group at the same time point.The ReHo.changes in hoth grouips were caleulated and statistically analyzed.Results There was no significant difference in MoCA scores between the ESRD group and control group(P=0.510).Compared with the control group,the ReHo values in the left middle frontal gyrus,bilateral middle cingulate,bilateral anterior cingulate,and left hippocampus were decreased(P<0.05,AlphaSim multiple comparisons corrction),the ReHo values in the right hippocampus and right inferior temporal gyrus were increased(P<0.05,AlphaSim multiple comparisons correction)in ESRD group..The correlation between the ReHo values of difference brain regions and the laboratory indicators in the ESRD group were not statistically significant(all P>0.05).Conclusion The overall cognition level of ESRD patients at interdialysis are normal,but consistency abnormality of spontaneous neural activity in multiple brain regions is found,which provides objective imaging basis for revealing the cognitive impairment of patients with ESRD after dialysis treatment.

关 键 词：终末期肾病 透析 静息态功能磁共振成像 局部一致性 认知障碍 

分 类 号：R692[医药卫生—泌尿科学] R445.2[医药卫生—外科学]