血液透析终末期肾病大脑MRI特征的临床研究  

Clinical Study of Brain MRI Features in Patients with End-stage Renal Disease on Hemodialysis

作　　者：何剑 袁仲飞 潘险峰 陈雪莲 HE Jian;YUAN Zhong-fei;PAN Xian-feng;CHEN Xue-lian(Department of Nephrology,The People's Hospital of Kaizhou District,Kaizhou 405400,Chongqing,China)

机构地区：[1]开州区人民医院肾脏内科,重庆开州405400

出　　处：《中国CT和MRI杂志》2024年第11期37-38,44,共3页Chinese Journal of CT and MRI

摘　　要：目的本研究旨在应用静息功能磁共振成像(Re-fMRI)研究终末期肾病(ESRD)血液透析患者脑内整体功能连接密度(GFCD)的变化。方法30例终末期肾病血液透析患者和30例健康对照组进行了Re-fMRI检查。采用包括蒙特利尔认知评估(MoCA)和贝克抑郁量表(BDI)在内的神经心理测试来评估受试者的神经认知和精神状况。对ESRD患者进行血液生化检查,采用双样本t检验来检验终末期肾病患者和健康对照组之间的GFCD差异。结果与健康对照组相比,终末期肾病患者双侧岛叶和背侧前扣带回(DACC)等突起网络中的GFCD显著增加,而GFCD与结构均值无明显相关性患者各脑区灰质体积在两组间表现出明显的差异。此外,右侧脑岛的连通度与SPKt/V呈显著负相关。结论我们的发现从整个大脑网络的角度揭示了ESRD患者显著网络相关区域的异常内在连接障碍模式。右侧脑岛与SpKt/V呈负相关,提示尿素清除增加可能会降低脑岛的病理活动性。Objective The purpose of this study was to investigate the changes of global functional connection density(GFCD)in the brain of hemodialysis patients with end-stage renal disease(ESRD)by resting functional magnetic resonance imaging(Re-fMRI).Methods Re-fMRI was performed in 30 patients with end-stage renal disease on hemodialysis and 30 healthy controls.Neuropsychological tests including the Montreal Cognitive Assessment(MoCA)and the Baker Depression Scale(BDI)were used to assess the subjects'neurocognitive and psychiatric status.Blood biochemical tests were performed in ESRD patients and a two-sample t test was used to detect differences in GFCD between patients with end-stage renal disease and healthy controls.Results Compared with healthy control group,GFCD in bilateral insular lobe and dorsal anterior cingulate gyrus(DACC)process networks increased significantly in patients with end-stage renal disease,while gray matter volume in each brain region showed significant differences between the two groups.In addition,the connectivity of the right insula was negatively correlated with SPKt/V.Conclusion Our findings reveal an abnormal pattern of intrinsic connectivity impairments in significant net-related regions in ESRD patients from a whole-brain network perspective.The right insula was negatively correlated with SpKt/V,suggesting that increased urea clearance may decrease the pathological activity of the insula.

关 键 词：静息功能磁共振成像 终末期肾病 脑内整体功能连接密度 

分 类 号：R445.2[医药卫生—影像医学与核医学]