使用磁共振波谱成像对老年耳鸣患者听皮层γ-氨基丁酸/谷氨酸定量的初步研究  

A preliminary quantitative study of gamma-aminobutyric acid/glutamate in auditory cortex of elderly tinnitus patients by MR spectral imaging

作　　者：卢雅雯 颜美静 杨一风 刘月红 傅彩霞 韩朝 李仕红 林光武 Lu Yawen;Yan Meijing;Yang Yifeng;Liu Yuehong;Fu Caixia;Han Zhao;Li Shihong;Lin Guangwu(Department of Radiology,Huadong Hospital,Fudan University,Shanghai,200040,P.R.China;Department of Otorhinolaryngology,Huadong Hospital,Fudan University,Shanghai,200040,P.R.China;Siemens(Shenzhen)Magnetic Resonance Co Ltd.,Shenzhen,Guangdong,518052,P.R.China)

机构地区：[1]复旦大学附属华东医院放射科,上海200040 [2]复旦大学附属华东医院耳鼻喉科,上海200040 [3]西门子(深圳)磁共振有限公司,广东深圳518052

出　　处：《老年医学与保健》2024年第2期390-396,共7页Geriatrics & Health Care

基　　金：华东医院重点学科建设项目(ZDXK2209);华东医院IIT项目(HDLC2022002)。

摘　　要：目的使用磁共振波谱(magnetic resonance spectroscopy,MRS)技术测量老年原发性耳鸣患者及性别、年龄匹配的无耳鸣受试者听觉皮层内神经递质GABA/Glu的水平,比较各代谢物质的差异及其与临床评分的相关性。方法收集2022年10月-2023年10月在复旦大学附属华东医院就诊的老年原发性耳鸣患者30例和年龄、性别匹配的无耳鸣受试者32例。使用MRS技术对受试者听觉皮层进行代谢物水平检测,并将其检测值与耳鸣障碍量表(tinnitus handicap Inventory,THI)评分、失眠严重程度指数量表(insomnia severity index,ISI)评分进行相关性分析。结果与对照组相比,耳鸣组右侧听觉皮层中谷氨酸(glutamate,Glu)(P<0.05)水平显著升高。耳鸣患者右侧听觉皮层内Glu水平与THI评分呈显著正相关(r=0.490,P<0.05)。结论老年耳鸣患者右侧听觉皮层中Glu水平显著升高,且与THI评分呈显著正相关,提示耳鸣的发病和痛苦程度可能与兴奋性递质的增量具有潜在关联。Objective To measure the content of neurotransmitter(gamma-aminobutyric acid/glutamate,GABA/Glu)in the auditory cortex of elderly patients with primary tinnitus and gender-and age-matched subjects without tinnitus by magnetic resonance spectroscopy(MRS),and compare the differences of various metabolites and their correlation with clinical scores.Methods 30 elderly patients with primary tinnitus(tinnitus group)and 32 gender-and age-matched subjects without tinnitus(control group)who visited Huadong Hospital Affiliated to Fudan University from October 2022 to October 2023 were collected.The contents of metabolites in the auditory cortex of all subjects were detected by MRS.Correlation analysis was conducted between their detected values and the scores of Tinnitus Handicap Inventory(THI)and Insomnia Severity Index(ISI).Results Compared with the control group,the level of Glu in the right auditory cortex of the tinnitus group was significantly higher(P<0.05).The level of Glu in the right auditory cortex of tinnitus patients was significantly positively correlated with THI score(r=0.490,P<0.05).Conclusion The level of Glu in the right auditory cortex of elderly tinnitus patients increased significantly,and was significantly positively correlated with THI score.It suggests that the onset and pain level of tinnitus may be potentially related to the increase of excitatory transmitters.

关 键 词：老年 耳鸣 磁共振波谱 Γ-氨基丁酸 谷氨酸 

分 类 号：R445.2[医药卫生—影像医学与核医学] R764.45[医药卫生—诊断学]