较短病程COPD患者中枢神经损伤的多脑区磁共振波谱成像  

Magnetic Resonance Spectroscopy Imaging of Central Nervous System Damage in Multiple Brain Regions of Patients with Short Course of COPD

作　　者：王宇[1] 翟飞 李荣凯[1] 宋亚茹[1] 王存强[2] 翟成凯[1] WANG Yu;ZHAI Fei;LI Rongkai;SONG Yaru;WANG Cunqiang;ZHAI Chengkai(Department of Respiratory Medicine,Xinxiang First People’s Hospital,Xinxiang 453000,China;Department of Imaging,Xinxiang First People’s Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市第一人民医院呼吸内科,河南新乡453000 [2]新乡市第一人民医院影像科,河南新乡453000

出　　处：《河南医学研究》2021年第31期5773-5776,共4页Henan Medical Research

基　　金：新乡市科技攻关计划项目(GG2020046)。

摘　　要：目的利用氢质子磁共振波谱成像(1H-MRS)技术检测病程较短的慢性阻塞性肺疾病(COPD)患者前额叶、丘脑、内囊生化代谢物指标水平,探讨其中枢神经损伤的可能机制及特点。方法随机选取2015年10月至2020年10月于新乡市第一人民医院呼吸内科住院的46例病程短于5 a的COPD患者作为研究组,同时选取45例健康人作为对照组。对所有入组对象进行1H-MRS检查,检测双侧前额叶、丘脑、内囊N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)峰,得出感兴趣脑区NAA/Cr和Cho/Cr值。分析NAA/Cr和Cho/Cr值与病程的相关性。结果研究组双侧前额叶、丘脑和内囊NAA/Cr值均小于对照组(P<0.05),右侧前额叶、双侧丘脑和双侧内囊Cho/Cr值大于对照组(P<0.05)。研究组双侧前额叶、丘脑和内囊NAA/Cr值均与病程呈负相关(P<0.05),Cho/Cr值均与病程呈正相关(P<0.05)。结论病程较短的COPD患者可能已经存在中枢神经系统损伤,损伤程度与病程呈正相关。1H-MRS技术有望成为COPD患者中枢神经系统损伤程度的一种客观检查手段。Objective To use proton magnetic resonance spectroscopy(1H-MRS)to detect the levels of biochemical metabolites in the prefrontal lobe,thalamus,and internal capsule of patients with short course of chronic obstructive pulmonary disease(COPD),and to explore the possible mechanism and characteristics of central nerve damage.Methods A total of 46 COPD patients with a disease course shorter than 5 years who were hospitalized in the Department of Respiratory Medicine,Xinxiang First People’s Hospital from October 2015 to October 2020 were randomly selected as study group.Meanwhile,45 healthy people were selected as control group.Perform 1H-MRS examination on all the enrolled subjects,and detect the peaks of N-acetylaspartic acid(NAA),choline(Cho)and creatine(Cr)on both sides of the prefrontal lobe,thalamus,and internal capsule to obtain NAA/Cr and Cho/Cr values.Analyze the correlation between NAA/Cr and Cho/Cr values and the course of the disease.Results The NAA/Cr values of bilateral prefrontal lobes,thalamus and internal capsule of study group were lower than those of control group(P<0.05).The Cho/Cr values of the right prefrontal lobe,bilateral thalamus and bilateral internal capsule of study group were greater than those of control group(P<0.05).The NAA/Cr values of the bilateral prefrontal lobe,thalamus and internal capsule of study group were negatively correlated with the course of the disease(P<0.05),and the Cho/Cr values were all positively correlated with the course of the disease(P<0.05).Conclusion Patients with a short course of COPD may already have damage to the central nervous system,and the degree of damage is positively correlated with the course of the disease.1H-MRS is expected to be an objective means of examining the degree of central nervous system damage in COPD patients.

关 键 词：慢性阻塞性肺疾病 中枢神经系统损伤 磁共振波谱成像 前额叶 内囊 丘脑 

分 类 号：R445.2[医药卫生—影像医学与核医学]