电针干预轻微型肝性脑病即刻脑效应的BOLD-fMRI研究  

The BOLD-fMRI Study on the Immediate Brain Effect of Electroacupuncture Intervention in Mild Hepatic Encephalopathy

作　　者：黄姬玲 康英杰 成建明[1] 魏翔宇 莫雪蕊 周峰峰 龚志刚[1] 黄炎文[1] 王辉[1] 谭文莉[1] 詹松华[1] HUANG Jiling;KANG Yingjie;CHENG Jianming;WEI Xiangyu;MO Xuerui;ZHOU Fengfeng;GONG Zhi-gang;HUANG Yanwen;WANG Hui;TAN Wenli;ZHAN Songhua(Department of Radiology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine;Shanghai University of Traditional Chinese Medicine;Department of Acupuncture and Moxibustion,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine;Department erf Liver Diseases,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine)

机构地区：[1]上海中医药大学附属曙光医院放射科 [2]上海中医药大学 [3]上海中医药大学附属曙光医院针灸科 [4]上海中医药大学附属曙光医院肝病科

出　　处：《中国医学计算机成像杂志》2022年第2期119-126,共8页Chinese Computed Medical Imaging

基　　金：国家自然科学基金面上项目(81573782);上海中医药大学重大成果培育项目(ZDCG201701);上海市科委临床医学领域项目(18401970300)。

摘　　要：目的:基于局部一致性(ReHo)及低频振幅(ALFF)的血氧水平依赖脑功能磁共振成像(BOLD-fMRI)分析方法,探讨正常人、肝硬化不伴脑病及伴轻微型肝性脑病(MHE)患者经电针刺激百会、神庭即刻的脑功能改变。方法:搜集23名健康志愿者(HC组)、18例无MHE的肝硬化患者(LC组)及17例MHE患者(MHE组),所有受试者于检查床上行电针百会、神庭穴电针刺激,分别于针刺前、针刺后即刻进行BOLD-fMRI扫描,所有数据利用RESTplus软件预处理图像数据并获取ALFF和ReHo值进行统计分析。结果:(1)HC组电针刺激前后,Re Ho值有差异的脑区包括右侧颞下回、右侧梭状回、右侧颞中回、左侧楔叶、两侧楔前叶等,ALFF值有差异的脑区包括右侧眶部额上回、右侧眶部额中回、右侧眶部额下回、尾状核、左侧内侧额上回、左侧前扣带和旁扣带脑回等。(2)LC组电针刺激前后,Re Ho值有差异的脑区包括两侧楔前叶、两侧后扣带回、右侧中央后回,两侧内侧和旁扣带脑回,ALFF值有差异的脑区包括右侧眶部额下回、右侧眶部额中回、右侧海马、右侧中央后回、右侧中央前回。(3)MHE组电针刺激前后,Re Ho值有差异的脑区包括右侧颞下回、右侧颞中回、右侧枕上回、左侧小脑,ALFF值有差异的脑区包括右侧眶部额上回、右侧眶部额下回、右侧尾状核、左侧顶下缘角回、左顶上回。结论:BOLD-f MRI技术为针刺百会、神庭治疗认知功能障碍的相关疾病提供可视化基础。针刺的即刻效应可以顺序、特异性地激活或失活MHE患者与认知功能相关的一些脑区的神经元活动,这种针刺效应的潜在神经机制可能是针灸对MHE认知功能障碍治疗作用的基础。Purpose:To observe the difference between electroacupuncture(EA)before and after EA in normal people,liver cirrhosis and mild hepatic encephalopathy(MHE)in Baihui and Shenting,and explores the brain function changes of EA at Baihui and Shenting by using the analysis method of blood oxygenation level dependent functional magnetic resonance imaging(BOLD-f MRI)scan of regional homogeneity(Re Ho)and amplitude of low frequency fluctuation(ALFF).Methods:Twenty-three healthy subjects(HC group),18 subjects with liver cirrhosis without MHE(LC group),and 17 MHE subjects(MHE group)were included in our study.All subjects received the first test before acupuncture.A BOLD-f MRI scan was performed in the resting state of the first phase,and the second scan was performed immediately after the electrical acupuncture stimulation.All the data were preprocessed by the RESTplus software and the ALFF and Re Ho values were obtained for statistical analysis.Results:(1)Comparing the two phases of the HC group,the brain areas with different Re Ho values included the right inferior temporal gyrus,the right fusiform gyrus,the right middle temporal gyrus,the left cuneiform lobe,and the two precuneus lobes,etc.The brain areas with different ALFF values included the right orbital superior frontal gyrus,the right orbital middle frontal gyrus,the right orbital inferior frontal gyrus,the caudate nucleus,the left medial superior frontal gyrus,the left anterior cingulate,and the lateral cingulate.(2)In the second stage comparison of the LC group,the brain areas with different Re Ho values included the precuneus,the posterior cingulate gyrus on both sides,the right central posterior gyrus,the medial and lateral cingulate gyrus on both sides.The brain regions with different ALFF values included the right orbital inferior frontal gyrus,the right orbital middle frontal gyrus,the right hippocampus,the right central posterior gyrus,and the right central anterior gyrus.(3)Compared with the MHE group,the brain areas with different Re Ho values included the

关 键 词：电针 血氧水平依赖脑功能磁共振 百会 神庭 轻微型肝性脑病 

分 类 号：R445.2[医药卫生—影像医学与核医学]