终末期肾病患者脑血流灌注改变:基于pCASL法MRI研究及与认知功能障碍的相关性

发布时间：2018-01-26 13:21

本文关键词： 磁共振成像伪连续式动脉自旋标记法脑灌注肾病终末期认知功能　出处：《放射学实践》2017年08期 　论文类型：期刊论文

【摘要】：目的:采用伪连续式动脉自旋标记法(pCASL)MRI对终末期肾病(ESRD)患者的脑灌注变化进行无创性测量,并讨论这种改变与认知功能障碍之间的关系。方法:将40例ESRD患者和40例性别、年龄相匹配的健康志愿者纳入研究,所有受试者进行实验室检查(血红蛋白、血肌酐和尿素)和神经心理学测试[包括数字连接试验-A(NCT-A)、数字符号试验(DST)、焦虑自评量表(SAS)和抑郁自评量表(SDS)],随后行pCASL-MRI检查,测量全脑、脑灰质和脑白质区的脑血流量(CBF)。对两组间的各项资料进行统计学分析。结果:ESRD组全脑、灰质和白质的CBF值均明显高于正常对照组,差异有统计学意义(P0.01);两组间DST、SAS和SDS分值的差异有统计学意义(P0.05),而NCT-A分值的差异无统计学意义(P0.05)。ESRD患者的全脑、灰质和白质的CBF值与血红蛋白含量间均呈明显负相关关系(P0.01),与DST分值亦呈负相关关系(P0.05);血红蛋白含量与DST分值间呈明显正相关关系(P0.05)。而血肌酐和尿素含量与各神经心理学量表分值间无显著相关关系(P0.05)。结论:ESRD患者的认知功能较健康人群减低,这种改变与其脑组织血流灌注以及血红蛋白含量具有显著相关性。
[Abstract]:Objective: to evaluate the changes of cerebral perfusion in patients with end-stage renal disease (ESRD) by pseudo-continuous arterial spin labeling (pCASL) MRI. Methods: 40 ESRD patients and 40 age-matched healthy volunteers were included in the study. All subjects underwent laboratory tests (hemoglobin, serum creatinine and urea) and neuropsychological tests. [The results included digital connection test (ANCT-An), digital symbol test (DST), self rating anxiety scale (SAS) and self rating depression scale (SDSs), followed by pCASL-MRI examination. The cerebral blood flow (CBF) of the whole brain, gray matter and white matter were measured. The data of the two groups were statistically analyzed. The CBF values of gray matter and white matter were significantly higher than that of normal control group (P 0.01). There was significant difference in the scores of SDS and SAS between the two groups (P 0.05), but there was no significant difference in the scores of NCT-A between the two groups. The CBF value of gray matter and white matter was significantly negatively correlated with hemoglobin content (P0.01A), and negatively correlated with DST score (P0.05%). There was a significant positive correlation between hemoglobin content and DST score (P 0.05), but there was no significant correlation between serum creatinine and urea content and scores of neuropsychological scales (P 0.05). Conclusion the cognitive function of ESRD patients is lower than that of healthy people. This change was significantly correlated with cerebral blood perfusion and hemoglobin content.
【作者单位】：南京军区南京总医院医学影像科;徐州医科大学医学影像学院;南京航空航天大学;南京军区南京总医院全军肾脏病研究所;
【基金】：国家自然科学基金(81671667,81471644) 中国博士后基金(2016T90445)
【分类号】：R445.2;R692.5
【正文快照】： 终末期肾病(end　stage　renal　disease,ESRD)是各种慢性肾脏疾病的终末阶段,患者的肾小球滤过率通常低于15mL/(min·1.73m2)[1-2]。人体内代谢产物的累积使ESRD患者经常出现不同程度的认知功能障碍,如人格改变、记忆力减退等[3],严重影响了患者的生活质量。集176层矢状面

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