帕金森病患者脑部氢质子MR波谱研究

发布时间：2018-03-28 21:45

本文选题：帕金森病　切入点：质子磁共振波谱　出处：《磁共振成像》2016年05期

【摘要】：目的应用氢质子磁共振波谱技术(1HMRS)检测帕金森病(PD)患者脑部代谢物变化。材料与方法搜集PD患者42例、健康体检者20例临床资料,进行头颅磁共振(MRI)和磁共振波谱(MRS)检查,测定中脑黑质、大脑苍白球、前额叶、海马区、楔回、背侧丘脑的脑代谢物N-乙酰天冬氨酸/肌酸(NAA/Cr)、N-乙酰天冬氨酸/胆碱化合物(NAA/Cho)、胆碱化合物/肌酸(Cho/Cr)比值;比较两组代谢物的差异性以及代谢物变化与UPDRS评分、病程的相关性。结果 (1)PD组NAA/Cr、NAA/Cho在双侧中脑黑质、苍白球、前额叶、海马区、楔回、背侧丘脑均显著低于对照组(P0.01);Cho/Cr在右侧海马区、右侧楔回、右背侧丘脑均高于对照组(P0.05)。(2)PD组双侧黑质(左r= 0.324,P=0.036,右r= 0.399,P=0.009)、右侧苍白球(r= 0.353,P=0.022)、左海马区(r= 0.388,P=0.011)、左楔回(r= 0.325,P=0.036)NAA/Cho与UPDRS呈负相关(均P0.05);(3)左侧苍白球Cho/Cr比值与病程呈正相关(r=0.327,P=0.034)。结论 PD患者脑部存在广泛神经元损害伴有部分胶质增生,脑代谢异常与临床病情严重程度正相关,并随病程的延长而逐渐加重。
[Abstract]:Objective to detect the changes of brain metabolites in patients with Parkinson's disease (PD) by hydrogen proton magnetic resonance spectroscopy (1H MRS). Materials and methods the clinical data of 42 PD patients and 20 healthy controls were collected, and the head magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) were performed. The ratio of N-acetylaspartic acid / creatine NAA / Na-acetylaspartic acid / choline compound (NAA / Cho), choline compound / creatine (Cho) was measured in the substantia nigra, globus pallidus, prefrontal lobe, hippocampal area, cuneate gyrus and dorsal thalamus. The differences of metabolites and their correlation with UPDRS score and course of disease were compared between the two groups. Results NAA / Cr 伪 NAA / Cho in bilateral midbrain substantia nigra, globus pallidus, prefrontal lobe, hippocampal area, wedged gyrus of PD group. The dorsal thalamus were significantly lower than those in the control group (P 0.01), and the right hippocampal area and the right cuneate gyrus were significantly lower than those in the control group. The bilateral substantia nigra (left r = 0.324g / P 0.036), the right (r = 0.399P) P ~ (0.009), the right globus pallidus (r = 0.353) (P ~ (0.022)), the left hippocampal area (r = 0.388P0.011), the left wedge gyrus (r = 0.325) ~ (0.036) NAA / Cho and UPDRS were negatively correlated with the course of disease in the right dorsal thalamus of PD group (all P 0.05). Conclusion there is a positive correlation between the Cho/Cr ratio of the left pallidus and the course of disease. Extensive neuronal damage associated with partial glial hyperplasia is present in PD patients. The abnormal brain metabolism was positively correlated with the severity of the disease, and gradually aggravated with the prolongation of the course of disease.
【作者单位】：汕头大学医学院第二附属医院神经内科;汕头大学医学院第二附属医院影像科;
【基金】：汕头大学医学院临床提升计划科研基金项目(编号:201409)~~
【分类号】：R445.2;R742.5

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