磁共振成像技术在2型糖尿病痛性神经病变患者中的应用  

Application of magnetic resonance imaging in patients with type 2 diabetic painful neuropathy

作　　者：王淑倩 惠灿灿 程雨微 胡秀娟 印小蓉 崔梦捷 黄沁仪 尹杨柳 孙艳[1] WANG Shuqian;HUI Cancan;CHENG Yuwei;HU Xiujuan;YIN Xiaorong;CUI Mengjie;HUANG Qinyi;YIN Yangliu;SUN Yan(Department of Geriatric Endocrinology,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230022)

机构地区：[1]安徽医科大学第一附属医院老年内分泌科,安徽合肥230022

出　　处：《实用临床医药杂志》2024年第8期16-21,共6页Journal of Clinical Medicine in Practice

基　　金：安徽省高校自然科学基金重点项目(KJ2018A0196);安徽省高校科研项目(2023AH053309);安徽医科大学校科研基金项目(2021xkj144);安徽医科大学第一附属医院临床研究项目(LCYJ2021YB006)。

摘　　要：目的观察磁共振成像技术在2型糖尿病痛性神经病变(PDN)患者脑结构及功能状况评估中的应用效果。方法选取在本院住院的2型糖尿病患者40例为研究对象,并分为糖尿病(DM)组(n=12)、糖尿病周围神经病变(DPN)组(n=14)和PDN组(n=14)。分析3组一般临床生化指标。分析并比较3组患者的脑结构及脑区功能。结果3组的年龄、糖尿病病程、收缩压、舒张压、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、游离脂肪酸(FFA)、白蛋白(ALB)、肌酐(Cr)、尿酸(UA)、估算肾小球滤过率(eGFR)、胱抑素(Cys-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPO-Ab)、血钙(Ca)比较,差异无统计学意义(P>0.05)。与DM组比较,DPN组的左侧角回灰质体积(GMV)减小,差异有统计学意义(P<0.05)。与DM组比较,PDN组的右侧小脑蚓部低频振幅(ALFF)及左侧内侧额上回低频振幅分数(fALFF)降低,差异有统计学意义(P<0.05)。结论DPN患者左侧角回GMV异常,可能与其合并认知功能障碍的风险较高相关。PDN患者右侧小脑蚓部ALFF及左侧内侧额上回fALFF降低,可能与其疼痛的发病机制相关。Objective To observe the application effect of magnetic resonance imaging technology in evaluating the brain structure and function of patients with type 2 diabetic painful neuropathy(PDN).Methods Forty patients with type 2 diabetes mellitus hospitalized in our hospital were selected as the study objects,and were divided into diabetes mellitus(DM)group(n=12),peripheral neuropathy(DPN)group(n=14)and PDN group(n=14).General clinical biochemical indexes of three groups were analyzed.The structural brain and function of brain area in three groups were compared.Results Age,duration of diabetes,systolic blood pressure,diastolic blood pressure,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),free fatty acid(FFA),albumin(ALB),creatinine(Cr),uric acid(UA),estimated glomerular filtration rate(eGFR),cystatin C(Cys-C),total cholesterol(TC),triglyceride(TG)of the three groups were compared,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPO-Ab)and serum calcium(Ca)in the three groups showed no significant differences(P>0.05).Compared with the DM group,the gray matter volume(GMV)in the DPN group was significantly decreased(P<0.05).Compared with the DM group,amplitude of low frequency fluctuation(ALFF)and fractional amplitude of low frequency fluctuation(fALFF)of left medial superiorfrontal gyrus in the PDN group were significantly decreased(P<0.05).Conclusion Abnormal GMV in the left angular gyrus in DPN patients may be associated with a higher risk of concomitant cognitive impairment.The decrease of ALFF in the right cerebellar vermis and fALFF in the left medial superior frontal gyrus in PDN patients may be related to the pathogenesis of pain.

关 键 词：糖尿病 糖尿病周围神经病变 糖尿病痛性神经病变 磁共振成像 灰质体积 低频振幅 

分 类 号：R587.1[医药卫生—内分泌] R445.2[医药卫生—内科学] R446[医药卫生—临床医学]