亚临床甲状腺功能减退症患者MRS的特点与其认知功能的相关性  

Correlation between the characteristics of magnetic resonance spectroscopy and cognitive function in subclinical hypothyroidism

作　　者：李艳捧[1] 杜晓猛 郎晓燕[1] 张斌[1] 刘迪[1] 陈静[1] 李晓东[1] 李娇娇[1] LI Yanpeng;DU Xiaomeng;LANG Xiaoyan;ZHANG Bin;LIU Di;CHEN Jing;LI Xiaodong;LI Jiaojiao(Department of Medical imaging, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China;Department of Radiotherapy, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China)

机构地区：[1]河北北方学院附属第一医院医学影像科,河北张家口075000 [2]河北北方学院附属第一医院放疗科,河北张家口075000

出　　处：《医学影像学杂志》2022年第6期906-910,共5页Journal of Medical Imaging

基　　金：河北省医学科学研究重点课题计划项目(编号:20180837)。

摘　　要：目的探讨亚临床甲状腺功能减退症(SCH)患者磁共振波谱成像(MRS)的特点与其认知功能的相关性。方法选取我院收治的SCH患者54例为观察组,选同期我院健康体检中心甲状腺功能正常54例为对照组。两组入组后均接受蒙特利尔认知评估量表(MoCA)检查,评价两组患者认知功能情况,并接受磁共振氢质子波谱成像(^(1)H magnetic resonance spectroscopy,^(1)H-MRS)扫描,检测额叶、海马、颞叶、基底节、丘脑、前扣带回中N-乙酰天冬氨酸(N-acetylasparte acid,NAA)、肌酸(creatine,Cr)及胆碱(choline,Cho)浓度水平及比值差异。分析MoCA评分与MRS代谢值间的相关性。结果观察组视结构与执行能力、注意力与集中、语言、延迟回忆及MoCA量表总评分均显著低于对照组(P<0.05);与对照组相比较,观察组优势半球侧海马、颞叶、丘脑及前扣带回NAA值均显著降低,且额叶、海马、丘脑及前扣带回NAA/Cr亦显著降低(P<0.05);SCH患者视结构与执行能力、注意力与集中、语言与额叶NAA/Cr比值呈正相关(r=0.463,P=0.008;r=0.459,P=0.027;r=0.434,P=0.033);延迟回忆与额叶、海马、丘脑及前扣带回NAA/Cr比值呈正相关(r=0.625,P=0.011;r=0.427,P=0.003;r=0.516,P=0.009;r=0.493,P=0.025)。结论SCH患者认知功能中视结构与执行能力、注意力与集中、语言、延迟回忆出现损害,且与优势半球侧额叶、海马、丘脑及前扣带回NAA/Cr呈正相关。Objective To explore the relationship between Mrs characteristics and cognitive function in patients with subclinical hypothyroidism.Methods 54 patients with subclinical hypothyroidism admitted to our hospital from May 2017 to December 2019 were selected as the case group,and 54 normal people with normal thyroid function and matched age,education level and gender in the health examination center of our hospital during the same period were selected as the control group.Both groups were assessed by the Montreal Cognitive Assessment Scale(MoCA),and the cognitive function of the two groups was assessed.The N-acetylaspartate(N-acetylaspartate)in the frontal lobe,hippocampus,temporal lobe,basal ganglia,thalamus and anterior cingulate gyrus was detected by 1H-MRS.The concentration and ratio of acid,NAA,creatine,Cr and choline were different.The correlation between MOCA score and Mrs metabolic value was analyzed.Results The total scores of visual structure and executive ability,attention and concentration,language,delayed recall and MOCA scale in the case group were significantly lower than those in the control group(P<0.05);compared with the control group,the NAA values of the dominant hemispheric hippocampus,temporal lobe,thalamus and anterior cingulate gyrus in the case group were significantly lower,and the NAA/CR of the frontal lobe,hippocampus,thalamus and anterior cingulate gyrus were also significantly lower(P<0.05);There was a positive correlation between visual structure and executive ability,attention and concentration,language and the ratio of NAA/Cr in frontal lobe(r=0.463,P=0.008;r=0.459,P=0.027;r=0.434,P=0.033);there was a positive correlation between delayed memory and the ratio of NAA/Cr in frontal lobe,hippocampus,thalamus and anterior cingulate gyrus(r=0.625,P=0.011;r=0.427,P=0.003;r=0.516,P=0.009;r=0.493,P=0.025).Conclusion Visual structure and executive ability attention and concentration,language and delayed memory were damaged in the cognitive function of patients with Sch,and they were positively

关 键 词：亚临床甲状腺功能减退症 磁共振成像 认知功能 

分 类 号：R581[医药卫生—内分泌] R445.2[医药卫生—内科学]