新诊断2型糖尿病患者静息态功能磁共振成像分数低频振幅研究

发布时间：2018-08-14 10:54

【摘要】：目的基于静息态功能磁共振成像(rs-f MRI)探讨不同血糖水平的新诊断2型糖尿病(T2DM)患者自发性脑神经活动的改变及其与认知功能的关系。方法选取2014年7月—2015年10月在陆军总医院内分泌科新诊断的T2DM患者41例。以入院时空腹血糖(FPG)水平进行分组,7.0 mmol/L≤FPG11.1 mmol/L为轻度高血糖组(A组,n=21),FPG≥11.1 mmol/L为严重高血糖组(B组,n=20);选取本院同期健康体检者为健康对照组(n=21)。采集3组受试者临床资料,行认知功能评分及rs-f MRI扫描。提取异常脑区的rs-f MRI分数低频振幅(fALFF)值,与临床资料、认知功能评分行相关性分析。结果 A、B组FPG、糖化血红蛋白(HbA_(1c))水平高于健康对照组,B组FPG、HbA_(1c)水平高于A组(P0.01)。3组认知功能评分比较,差异均无统计学意义(P0.05)。3组双侧额上回、后扣带回/楔前叶、顶下小叶、内侧前额叶皮质fALFF值均高于全脑平均水平(P0.05)。A、B组左侧额上回、右侧枕中回、右侧小脑后叶、左侧中央前回fALFF值低于健康对照组,右侧额上回fALFF值高于健康对照组(P0.05,FDR校正)。B组左侧额中回fALFF值高于A组,右侧中央前回fALFF值低于A组(P0.05,FDR校正)。新诊断T2DM患者右侧小脑后叶fALFF值与胰岛素抵抗指数(HOMA-IR)(r=-0.470,P0.05)、HbA_(1c)(r=-0.348,P0.05)呈负相关;新诊断T2DM患者右侧中央前回fALFF值与HbA_(1c)(r=-0.518,P0.05)、FPG(r=-0.528,P0.05)呈负相关;左侧额中回fALFF值与HbA_(1c)(r=0.640,P0.05)、FPG(r=0.738,P0.05)呈正相关。结论新诊断T2DM患者在诊断早期已存在右侧小脑后叶、右侧枕中回等脑区自发性神经活动下降;部分脑区的改变与血糖控制或胰岛素抵抗密切相关,这些脑区的fALFF值进一步阐释了T2DM相关性认知障碍的神经生理学基础。
[Abstract]:Objective based on resting functional magnetic resonance imaging (rs-f MRI) to investigate the changes of spontaneous cerebral nerve activity in patients with type 2 diabetes mellitus (T2DM) with different blood glucose levels and its relationship with cognitive function. Methods 41 newly diagnosed T2DM patients from July 2014 to October 2015 in Endocrinology Department of Army General Hospital were selected. Fasting blood glucose (FPG) levels were divided into mild hyperglycemia group (group A, n = 21) and severe hyperglycemia group (group B, n = 20) with fasting blood glucose (FPG) of 7. 0 mmol/L 鈮，

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