基于磁共振动脉自旋标记成像对阻塞性睡眠呼吸暂停低通气综合征的脑血流灌注研究

发布时间：2018-04-13 13:19

本文选题：动脉自旋标记法 + 阻塞性睡眠呼吸暂停低通气综合征　；参考：《南昌大学》2017年硕士论文

【摘要】：目的利用动脉自旋标记法(ASL)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者在静息状态下脑血流灌注的改变进行量化分析,进一步探索分析OSAHS患者脑血流灌注改变与脑功能之间的关系。材料与方法1.招募了2013年8月至2016年1月在我院呼吸科就诊的男性重度OSAHS患者30例及同期年龄、教育程度相匹配的男性正常睡眠者(对照组)30例,采集静息状态下的伪连续性动脉自旋标记(PCASL)脑部序列数据,经过数据后处理得出局部脑血流量(rCBF)。2.在脑功能数据扫描当天,所有受试者均接受蒙特利尔认知(Montreal cognitive function,MoCA)评估量表评估及爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)评估。3.采用MATLAB2010a平台上的ASL-tbx软件将原始数据进行预处理;采用REST plus软件对患者组与对照组各脑区间rCBF值进行组间两样本t检验,得到有统计学差异的脑区;然后采用IBM SPSS19.0统计软件对rCBF值有差异的脑区与临床量表评分进行Pearson相关性分析。结果1.OSAHS患者组与正常对照组(GSs)的年龄及受教育年限没有明显的统计学差异(P0.05);OSAHS患者组的快速动眼睡眠阶段占总睡眠时间百分比、总睡眠时间及最低SaO2较正常对照组更低,AHI值、SaO290%值及微觉醒指数明显高于对照组(P0.05)。2.与GSs相比,OSAHS组的左侧小脑后叶、左侧颞叶、右侧额中回及双侧海马旁回的rCBF减低;rCBF增高的脑区主要位于双侧额上回。3.右侧海马旁回的rCBF值与觉醒指数呈正相关(r=0.365,P=0.047),左侧额上回rCBF值与最长呼吸暂停时间呈正相关(r=0.422,P=0.020),右侧额上回rCBF值与最长呼吸暂停时间呈正相关(r=0.447,P=0.013)。结论1.OSAHS患者存在左侧小脑后叶、左侧颞叶、右侧额中回、双侧海马旁回及双侧额上回等多个脑区的脑血流灌注异常。2.这些灌注异常脑区的rCBF值与临床量表评分间存在着相关性,推测这些脑区的rCBF的改变可能是OSAHS患者临床症状产生的主要机制之一。
[Abstract]:Objective to analyze quantitatively the changes of cerebral blood flow perfusion in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) under resting state by arterial spin labeling (ASL).To explore the relationship between cerebral blood flow perfusion and brain function in patients with OSAHS.Materials and methods 1.From August 2013 to January 2016, 30 male patients with severe OSAHS and 30 men with matched age and education were recruited (control group, 30 cases).The brain sequence data of pseudo-continuous arterial spin labeling (PCASL) under resting state were collected and the local cerebral blood flow (rCBFV) was obtained by processing the data.On the same day of brain function data scanning, all subjects were assessed with Montreal cognitive function Mocha and Epworth sleepiness scale-ESS.3.The original data were preprocessed by ASL-tbx software on MATLAB2010a platform, and the REST plus software was used to test the rCBF value of each brain interval between the patients group and the control group, and the brain regions with statistical difference were obtained.Then IBM SPSS19.0 software was used to analyze the Pearson correlation between the brain regions with different rCBF values and the clinical scale scores.Results there was no significant difference in age and years of education between the 1.OSAHS group and the normal control group. The REM sleep stage in the OSAHS group was as a percentage of the total sleep time.The total sleep time and minimum SaO2 were significantly lower than those of the control group (P < 0.01). The Sao _ (290%) value and the microarousal index were significantly higher than those in the control group (P < 0.05).Compared with GSs group, the areas with decreased rCBF in left posterior cerebellar lobe, left temporal lobe, right middle frontal gyrus and bilateral pariprahippocampal gyrus were mainly located in bilateral superior frontal gyrus.The rCBF value of right parahippocampal gyrus was positively correlated with the arousal index, the rCBF value of left superior frontal gyrus was positively correlated with the longest apnea time, the rCBF value of right superior frontal gyrus was positively correlated with the longest apnea time, and the rCBF value of right superior frontal gyrus was positively correlated with the longest apnea time.Conclusion in patients with 1.OSAHS, the cerebral blood perfusion is abnormal in the left posterior cerebellar lobe, left temporal lobe, right middle frontal gyrus, bilateral pariprahippocampal gyrus and bilateral superior frontal gyrus.There is a correlation between the rCBF values of these abnormal cerebral regions and the clinical scale scores. It is speculated that the changes of rCBF in these brain regions may be one of the main mechanisms of clinical symptoms in OSAHS patients.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766;R445.2

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