肾性继发性甲状旁腺功能亢进症患者大脑影像学表现与认知功能的相关性研究

发布时间：2018-06-16 18:39

本文选题：慢性肾衰竭 + 甲状旁腺功能亢进症　；参考：《中国医科大学学报》2017年08期

【摘要】：目的通过分析颅脑磁共振(MRI)弥散加权成像(DWI)、扩散张量成像(DTI)表现及血清学指标与认知功能量表得分,探讨肾性继发性甲状旁腺功能亢进症(SHPT)患者认知功能变化与MRI表现之间的关系。方法选取肾性SHPT住院患者49例,采用Mo CA及MMSE功能量表评价认知功能,使用颅脑MRI扫描并选用部分异向性(FA)、表观弥散系数(ADC)评价各脑功能区白质功能,同时记录血清检验指标,统计并分析认知功能评分与各脑白质功能区MRI得分及生化指标间的相关性。结果肾性SHPT患者额叶区FA及ADC得分与MMSE语言、记忆功能得分相关,顶叶区FA及ADC评分与Mo CA视空间执行能力得分相关,其余各功能区MRI得分与认知功能量表得分之间无明显相关性。肾性SHPT患者认知功能与全段甲状旁腺素(i PTH)水平呈负相关,与受教育水平呈正相关,与性别、年龄、血压、血清钙水平等无明显相关性。结论肾性SHPT患者i PTH及受教育水平与认知功能存在相关性;颅脑MRI的额叶及顶叶FA与ADC值对判断肾性SHPT患者认知功能水平及功能损伤定位具有较高的诊断价值,值得临床推广。
[Abstract]:Objective to analyze the diffusion-weighted imaging (DWI), diffusive Zhang Liang imaging (DWI), serological indexes and cognitive function scale (MCS) of craniocerebral MRI. To investigate the relationship between cognitive function and MRI findings in patients with renal secondary hyperparathyroidism. Methods A total of 49 patients with renal SHPT were selected to evaluate cognitive function with Mo CA and MMSE functional scale. Brain MRI was used to evaluate the white matter function of various brain function areas. Brain MRI was used to evaluate the white matter function of each brain function area with partial heteromorphism FAP and apparent diffusion coefficient (ADCC). Serum test indexes were recorded at the same time. The correlation of cognitive function scores with MRI scores and biochemical indexes in white matter functional areas was analyzed. Results the scores of FA and ADC in frontal lobe area were correlated with MMSE language and memory function in renal SHPT patients, and FA and ADC scores in parietal lobe area were correlated with visual executive ability of Mo-CA. There was no significant correlation between MRI scores and cognitive function scale scores in other functional areas. The cognitive function of patients with renal SHPT was negatively correlated with the whole level of parathyroid hormone (PTH), and positively correlated with the level of education, but not with sex, age, blood pressure, serum calcium level and so on. Conclusion there is a correlation between I PTH, education level and cognitive function in patients with renal SHPT, FA and ADC values in frontal and parietal lobe of craniocerebral MRI are valuable in the diagnosis of cognitive function and location of functional injury in patients with renal SHPT, and it is worth popularizing in clinic.
【作者单位】：安徽医科大学第二附属医院肾内科;安徽医科大学第二附属医院放射科;
【基金】：安徽省公益性研究联动计划项目(1604f0804021) 安徽医科大学校临床科学研究项目(2015xkj110)
【分类号】：R582.1

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