代谢综合征患者听皮层区磁共振氢质子波谱分析

发布时间：2018-07-08 21:41

本文选题：代谢综合征 + 听觉皮层　；参考：《听力学及言语疾病杂志》2017年01期

【摘要】：目的探讨磁共振氢质子波谱(1 H magnetic resonance spectroscopy,1 H-MRS)技术对代谢综合征患者听皮层神经细胞损伤的早期预警作用。方法随机抽取确诊的代谢综合征患者142例,根据纯音听阈将其分为代谢综合征并双侧耳聋组(23例)、代谢综合征并单侧耳聋组(20例)、单纯代谢综合征组(99例),以健康志愿者15例为正常对照组,各组行双侧颞横回听皮层1 H-MRS检测,根据听皮层神经代谢产物峰下面积计算N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)、N-乙酰天门冬氨酸/胆碱(NAA/Cho)值,比较各组间上述各项指标的差异;根据ROC曲线下面积判定上述各指标诊断早期代谢综合征并感音神经性听力损失的敏感性及特异性。结果与正常对照组对应侧相比,单纯代谢综合征组听皮层神经代谢产物NAA/Cho降低,Cho/Cr升高(P0.05);代谢综合征合并双侧耳聋组与单纯代谢综合征组比较NAA/Cho降低,Cho/Cr升高(P0.05);代谢综合征合并单侧耳聋组患侧和健侧NAA/Cho均下降,且患侧NAA/Cho较健侧降低更显著(P0.05)。代谢综合征患者颞横回NAA/Cho的ROC曲线下面积为81%时准确性较高,且当NAA/Cho为1.82时可以作为总体代谢综合征患者与代谢综合征合并感音神经性聋的分界指标,其余神经代谢产物ROC曲线下面积均50%。结论听皮层磁共振氢质子波谱分析听皮层神经代谢产物NAA/Cho有可能作为判定代谢综合征人群发生感音神经性聋的早期预警指标。
[Abstract]:Objective to investigate the early warning effect of 1H magnetic resonance spectroscopy (1H-MRS) on neuronal damage in auditory cortex in patients with metabolic syndrome. Methods 142 patients with metabolic syndrome were randomly selected. According to pure tone hearing threshold, it was divided into metabolic syndrome with bilateral deafness group (23 cases), metabolic syndrome with unilateral deafness group (20 cases), simple metabolic syndrome group (99 cases), and 15 healthy volunteers as normal control group. 1H-MRS was detected in bilateral transverse temporal gyrus auditory cortex. The values of N-acetylaspartate / creatine (NAA- / creatine), choline / creatine (ChorCr), inositol / creatine (MI / Cr) and N-acetylaspartate / choline (NAAP-Cho) were calculated according to the subpeak area of neurometabolites of auditory cortex. The sensitivity and specificity of the above indexes in the diagnosis of early metabolic syndrome and sensorineural hearing loss were determined according to the area under the ROC curve. Results compared with the corresponding side of the normal control group, In simple metabolic syndrome group, NAA / Cho decreased ChoP / Cr level (P0.05), NAA / Cho decreased significantly compared with simple metabolic syndrome group (P0.05), NAA / Cho decreased in affected side and healthy side in metabolic syndrome with unilateral deafness group (P0.05), NAA / Cho level in bilateral deafness group was lower than that in control group (P0.05), and NAA / Cho level in unilateral hearing loss group was significantly lower than that in control group (P0.05). NAA / Cho in the affected side was significantly lower than that in the healthy side (P 0.05). The accuracy of the area under the ROC curve of NAA / Cho in metabolic syndrome patients was 81. When NAA / Cho was 1.82, NAA / Cho could be used as a dividing line between patients with total metabolic syndrome and metabolic syndrome with sensorineural hearing loss. The area under the ROC curve of other neurometabolites was 50. Conclusion Nuclear magnetic resonance proton spectroscopy analysis of NAA / Cho may be used as an early warning index to determine the occurrence of sensorineural deafness in patients with metabolic syndrome.
【作者单位】：河北医科大学第二医院耳鼻咽喉头颈外科;正定县人民医院耳鼻咽喉头颈外科;河北医科大学第一医院耳鼻喉实验室;
【分类号】：R589;R764

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