OSAHS患者认知功能与磁共振弥散张量成像的相关性分析  

Correlation analysis between cognitive function and DIFFUSION tensor imaging in patients with obstructive sleep apnea hypopnea syndrome

作　　者：廖明朗 李传资 黄垂志 冯勇军[2] 石慧芳[3] Liao Minglang;Li Chuanzi;Huang Chuizhi;Feng Yongjun;Shi Huifang(Department of Radiology,the Second Affiliated Hospital of Hainan Medical University,Hainan 570311,China)

机构地区：[1]海南医学院第二附属医院放射科,海口570311 [2]海南医学院第二附属医院耳鼻喉科,海口570311 [3]海南医学院第二附属医院呼吸内科,海口570311

出　　处：《脑与神经疾病杂志》2021年第10期623-628,共6页Journal of Brain and Nervous Diseases

基　　金：琼卫2013资助-65号。

摘　　要：目的分析阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者认知功能与磁共振弥散张量成像(diffusion tensor imaging,DTI)相关性。方法选取2016年08月至2019年07月在海南医学院第二附属医院诊治的40例OSAHS患者(中度组20例,重度组20例)及同期健康志愿者20例(对照组),行常规MRI及DTI检查,并填写中文版简易智能精神状态检查量表(minimentalstateexamination,MMSE),对三组入选者资料进行相关性分析。结果(1)三组入选者在记忆力、注意力和计算力、回忆能力及MMSE总分见比较差异有统计学意义(P<0.05);(2)OSAHS中度组与重度组患者双侧额叶白质、前扣带回、后角周围白质及海马旁回等解剖结构的FA值分别与对照组比较明显降低(P<0.0167);OSAHS中度组与重度组患者双侧额叶白质、前扣带回及后角周围白质等解剖结构的ADC值分别与对照组比较明显升高(P<0.0167);(3)控制年龄、文化程度后选取右侧半球额叶白质、前扣带回、后角周围白质及海马旁回进行分析。记忆力与右侧额叶白质、前扣带回及海马旁回FA值呈正相关(r=0.526、0.467及0.573,P均<0.05);注意力和计算力与右侧额叶白质及前扣带回FA值呈正相关(r=0.354、0.387,均P<0.05);回忆能力与右侧额叶白质、前扣带回及海马旁回FA值呈正相关(r=0.475、0.375及0.377,均P<0.05)。结论DTI是一种非侵入性评价现脑白质完整性、致密性及平行性的影像学检查方法,与MMSE量表结合可反映OSAHS患者认知功能损害程度。OSAHS患者存在多种不同走向的白质纤维受损,记忆力、注意力和计算力、回忆能力受损程度与右侧额叶白质、前扣带回及海马旁回受损程度呈正相关。Objective To analyze the correlation between cognitive function and diffusion tensor imaging(DTI)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From August 2016 to July 2019,40 patients with OSAHS(moderate group,20 cases,severe group,20 cases)and 20 healthy volunteers(control group)were selected for routine MRI and DTI examination,and the Chinese version of Mini Mental State Examination(MMSE)was filled in,and the data of the three groups were analyzed.Results(1)there were significant differences in memory,attention and calculation ability,recall ability and MMSE total score among the three groups(P<0.05);(2)FA values of bilateral frontal white matter,anterior cingulate gyrus,posterior horn surrounding white matter and parahippocampal gyrus in moderate and severe OSAHS groups were significantly lower than those in control group(P<0.0167);ADC values of bilateral frontal white matter,anterior cingulate cortex and posterior horn surrounding white matter in moderate and severe OSAHS groups were significantly higher than those in control group(P<0.0167);(3)after controlling age and education level,the right hemisphere white matter in frontal lobe,anterior cingulate gyrus,posterior horn surrounding white matter and parahippocampal gyrus were analyzed.Memory was positively correlated with FA values of right frontal white matter,anterior cingulate gyrus and parahippocampal gyrus(r=0.526,0.467 and 0.573,all P<0.05);attention and computational power were positively correlated with FA values of right frontal white matter and anterior cingulate gyrus(r=0.354,0.387,respectively),Recall ability was positively correlated with FA values in right frontal white matter,anterior cingulate gyrus and parahippocampal gyrus(r=0.475,0.375 and 0.377,all P<0.05).Conclusion DTI is a noninvasive imaging method to evaluate the integrity,compactness and parallelism of white matter in the brain.Combined with MMSE,DTI can reflect the degree of cognitive impairment in patients with OSAHS.The degree of impairment of memor

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 认知功能 磁共振弥散张量成像 

分 类 号：R747.9[医药卫生—神经病学与精神病学]