脑血管间隙扩大对慢性失眠的诊断价值探究  

Exploration of the Diagnostic Value of Cerebral Vascular Gap Enlargement in Chronic Insomnia

作　　者：魏景洋 王阔 杨晓龙 李莹杰 张明星 梁爽 WEI Jing-yang(Mudanjiang Medical University Affiliated Second Hospital Imaging Department,Mudanjiang 157000,Heilongjiang,China)

机构地区：[1]牡丹江医科大学附属第二医院影像科,黑龙江牡丹江157000 [2]哈尔滨医科大学附属肿瘤医院放射科,黑龙江哈尔滨150000

出　　处：《牡丹江医科大学学报》2025年第2期106-110,共5页Journal of Mudanjiang Medical University

基　　金：黑龙江省卫生健康委科研项目(20230909010413)。

摘　　要：目的探讨慢性失眠患者异常扩大的脑血管间隙(enlarged perivascular space,EPVS)对慢性失眠的诊断价值。方法收集于2023年1月至2024年9月在牡丹江医科大学附属第二医院就诊并经临床确诊为慢性失眠的患者27例作为慢性失眠组,并且招募35例年龄、性别与病例组相匹配的健康人群作为健康对照组,所有受试对象均符合纳入排除标准。采用视觉量化法根据其头部核磁共振(Magnetic Resonance Imaging,MRI)显示的EPVS数量对所有受试对象进行EPVS分级,在影像学检查前收集所有受试对象的年龄、性别及失眠年限同时填写评估量表计算匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI),比较各指标在两组间的差异并且对慢性失眠患者的EPVS分级与各年龄、病程与PSQI指数进行Pearson相关性分析,使用ROC曲线评估EPVS分级对慢性失眠的诊断价值。结果慢性失眠组在基底节区EPVS分级(Z=-2.49,P=0.013)及半卵圆中心EPVS分级(Z=-2.10,P=0.036)、失眠年限(Z=6.22,P<0.001)及PSQI得分(t=11.95,P<0.001)均明显高于健康对照组,相关性分析结果显示基底节区EPVS分级与失眠年限(r=0.41,P=0.032)及PSQI(r=0.39,P=0.044)呈正相关。半卵圆中心的EPVS分级同样与失眠年限(r=0.51,P=0.016)及PSQI(r=0.42,P=0.029)呈正相关。ROC分析显示基底节区EPVS分级(AUC=0.68,P=0.018)与半卵圆中心的EPVS分级(AUC=0.65,P=0.046)具有诊断慢性失眠的能力。结论慢性失眠患者的EPVS数量高于健康人群,EPVS与慢性失眠相关,可能作为临床诊断慢性失眠的生物标志物。Objective To investigate the diagnostic value of abnormally enlarged perivascular spaces(EPVS)in patients with chronic insomnia.Methods A total of 27 patients diagnosed with chronic insomnia at the Second Affiliated Hospital of Mudanjiang Medical University from January 2023 to September^(2)024 were included in the case group,and 35 healthy age-and gender-matched individuals were recruited as the control group.All participants met the inclusion and exclusion criteria.Visual quantification was used to classify all subjects based on the number of EPVS observed on their head magnetic resonance imaging(MRI).Prior to imaging examination,the age,gender,and duration of insomnia of all subjects were recorded,and the Pittsburgh Sleep Quality Index(PSQI)was completed.Differences in each index between the two groups were compared,and Pearson correlation analysis was performed between the EPVS classification in chronic insomnia patients and age,disease duration,and PSQI score.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of EPVS classification for chronic insomnia.Results The chronic insomnia group showed significantly higher levels of EPVS grading in the basal ganglia region(Z=-2.49,P=0.013),in the semioval center(Z=-2.10,P=0.036),as well as in insomnia duration(Z=6.22,P<0.001)and PSQI score(t=11.95,P<0.001)compared to the healthy control group.Correlation analysis revealed a positive correlation between EPVS grading in the basal ganglia region and both insomnia duration(r=0.41,P=0.032)and PSQI score(r=0.39,P=0.044).Similarly,EPVS grading in the semioval center was positively correlated with both insomnia duration(r=0.51,P=0.016)and PSQI score(r=0.42,P=0.029).ROC analysis showed that the EPVS grading in the basal ganglia(AUC=0.68,P=0.018)and the semioval center(AUC=0.65,P=0.046)are capable of diagnosing chronic insomnia,with statistically significant results(P<0.05).Conclusion The number of EPVS in patients with chronic insomnia is higher than in healthy individuals,and EPVS

关 键 词：慢性失眠 血管周围间隙 匹兹堡睡眠质量指数 

分 类 号：R445.2[医药卫生—影像医学与核医学]