阿尔茨海默病患者的酰胺质子转移加权磁共振成像研究  

Amide Proton Transfer-weighted Imaging of Patients with Alzheimer’s Disease

作　　者：李经纬 李群[1,2,4] 杨硕 冉志蓉 郑明明 朱囡囡 程鹏 陈苑苑[1,2,3] 石丽 张许来 LI Jingwei;LI Qun;YANG Shuo;RAN Zhirong;ZHENG Mingming;ZHU Nannan;CHENG Peng;CHEN Yuanyuan;SHI Li;ZHANG Xulai(Affiliated Psychological Hospital of Anhui Medical University,Hefei 230022,China;Anhui Mental Health Center,Hefei 230022,China;Department of Geriatrics,Hefei Fourth People's Hospital,Hefei 230022,China;Imaging Department,Hefei Fourth People's Hospital,Hefei 230022,China;Department of Psychiatry,Hefei Fourth People's Hospital,Hefei 230022,China;Anhui Clinical Research Center for Mental Disorders,Hefei 230022,China)

机构地区：[1]安徽医科大学附属心理医院,安徽省合肥市230022 [2]安徽省精神卫生中心,安徽省合肥市230022 [3]第四人民医院老年科,安徽省合肥市230022 [4]安徽省合肥市第四人民医院影像科,230022 [5]安徽省合肥市第四人民医院精神科,230022 [6]安徽省精神心理疾病临床医学研究中心,安徽省合肥市230022

出　　处：《中国全科医学》2022年第24期3005-3012,共8页Chinese General Practice

基　　金：国家重点研发计划(2016YFC1305902);安徽省中央引导地方科技发展专项资金(S2020b07030004)。

摘　　要：背景随着全球老龄化进程的加剧,阿尔茨海默病(AD)的发病率也在逐年递增,由于其早期症状不典型,导致临床诊断困难。寻找新的可靠的影像学技术、提高早期AD的临床诊断率已成为医学研究中的重要挑战。目的探讨AD患者脑内酰胺质子含量变化与临床症状之间的关系。方法选取2019年11月至2021年8月于安徽医科大学附属心理医院首次门诊就诊及住院治疗的55岁以上AD患者为研究对象,归为AD组(n=41例)。同期招募健康志愿者纳入健康对照组(n=37)。采用简易智力状态检查量表(MMSE)与阿尔茨海默病病理行为评分表(BEHAVE-AD)分别评定两组认知功能与精神行为情况,运用酰胺质子转移加权(APT w)磁共振成像对两组受试者行颅脑摄片成像,采用Spearman秩相关分析探究脑内酰胺质子含量与认知功能、精神症状因子的关系。结果(1)AD组与健康对照组的MMSE和BEHAVE-AD评分比较,差异有统计学意义(P<0.05)。AD组2 ut下右侧海马、2 ut下左侧海马、2 ut下海马(总)、4 ut下右侧海马、4 ut下左侧海马、4 ut下海马(总)酰胺质子含量高于健康对照组,3 ut下左侧海马、3 ut下海马(总)区酰胺质子含量低于健康对照组(P<0.05)。(2)Spearman秩相关分析结果显示:2 ut下右侧海马区酰胺质子含量与偏执和妄想因子(r_(s)=0.574,P=0.040)、幻觉因子(r_(s)=0.595,P=0.032)、日夜节律紊乱因子(r_(s)=0.591,P=0.033)呈正相关;3 ut下右侧海马区酰胺质子含量与偏执和妄想因子(r_(s)=0.588,P=0.034)、幻觉因子(r_(s)=0.572,P=0.041)、日夜节律紊乱因子(r_(s)=0.650,P=0.016)呈正相关;3 ut下左侧海马区酰胺质子含量与定向力呈负相关(r_(s)=-0.590,P=0.034);3 ut下海马(总)酰胺质子含量与偏执和妄想因子(r_(s)=0.625,P=0.022)、幻觉因子(r_(s)=0.606,P=0.028)、日夜节律紊乱因子(r_(s)=0.611,P=0.026)呈正相关;4 ut下右侧海马区酰胺质子含量与情感障碍因子(r_(s)=0.615,P=0.025)呈正相�Background Alzheimer’s disease(AD)prevalence is increasing as aging advances worldwide,but its diagnosis is difficult due to atypical early clinical symptoms.Therefore,exploring new and reliable imaging techniques to improve early diagnosis rate of AD has become an important challenge in medical research.Objective To assess the correlation of amide proton content in brain with clinical symptoms of AD.Methods 41 AD patients over 55 years old in Affiliated Psychological Hospital of Anhui Medical University were enrolled from November 2019 to August 2021,and 37 healthy volunteers were recruited at the same time.The Mini-Mental State Examination(MMSE)and the Behavioral Pathology in Alzheimer’s Disease Rating Scale(BEHAVE-AD)were used to evaluate the cognitive function,and behavioral symptoms,respectively.APTw MRI was used to take cephalograms.Spearman rank correlation analysis was used to explore the relationship between content of brain amide protons and psychiatric symptom factors in AD patients.Results(1)The results showed that the MMSE and BEHAVE-AD scores were significantly different between AD patients and healthy controls(P<0.05).AD patients had significantly increased contents of amide protons in the right,left,and total hippocampus under 2 ut,and in the right,left and total hippocampus under 4 ut,than did healthy controls(P<0.05).But the contents of amide protons in the left and total hippocampus under 3 ut in AD patients were lower than those in healthy controls(P<0.05).(2)Spearman rank correlation analysis showed that the content of amide protons in the right hippocampus under 2 ut was positively correlated with the scores of delusional ideation factor(r_(s)=0.574,P=0.040)and hallucinations factor(r_(s)=0.595,P=0.032)and diurnal rhythm disturbances factor(r_(s)=0.591,P=0.033).Under 3 ut,the content of amide protons in the right hippocampus was positively correlated with the scores of delusional ideation factor(r_(s)=0.588,P=0.034)and hallucinations factor(r_(s)=0.572,P=0.041)and diurnal rhythm disturba

关 键 词：阿尔茨海默病 磁共振成像 神经系统疾病 老年人 认知 数据相关性 

分 类 号：R745.7[医药卫生—神经病学与精神病学]