不同进展阶段肝性脑病患者大脑静息态功能和脑代谢研究

发布时间：2018-08-11 12:19

【摘要】：目的:探讨肝性脑病(HE)不同严重程度患者大脑静息态低频振荡幅度以及脑代谢的差异,为患者的治疗提供依据。方法:选取本院2014年5月-2016年5月的32例HE患者进行研究,依据其病情的严重程度分为两组,轻度肝性脑病(MHE)组22例,重度肝性脑病(OHE)组10例。选取同期进行身体检查的健康受试者13例作为对照组,分别使用BOLD-fMRI、磁共振波谱检查三组患者的静息状态下脑功能情况,分析脑代谢物的异常情况。结果:与对照组相比,MHE与OHE组患者的脑部默认网络区和小脑区内的分数化低频振荡幅度值显著降低,颞中回内、额中回和脑室旁白质区的分数化低频振荡幅度则显著升高。MHE组患者脑代谢物Cho/Cr(0.93±0.11,0.80±0.16)与mI/Cr(0.26±0.08,0.20±0.06)显著大于OHE组(P0.05),MHE组和OHE组NAA/Cr分别为1.93±0.15、2.03±0.22,差异无统计学意义(P=0.51)。HE患者代谢物峰值下面积比值均显著低于正常对照组(NAA/Cr 2.78±0.19,Cho/Cr 1.20±0.13,mI/Cr 0.43±0.05,P0.05)。结论:HE越严重其静息态默认网络区和小脑区内的低频振荡幅度降低,颞中回内、额中回和脑室旁白质区低频震荡幅度则明显升高。HE患者脑代谢物峰下面积比值越低提示病情越严重,为其诊断和治疗提供参考。
[Abstract]:Objective: to investigate the amplitude of low frequency oscillations and brain metabolism in patients with hepatic encephalopathy (HE) with different severity. Methods: a total of 32 patients with HE were selected from May 2014 to May 2016. According to the severity of the disease, they were divided into two groups: 22 patients with mild hepatic encephalopathy (MHE) and 10 patients with severe hepatic encephalopathy (OHE). Thirteen healthy subjects who underwent physical examination at the same time were selected as the control group. The brain function in resting state was examined by using BOLD-fMRI and magnetic resonance spectroscopy respectively, and the abnormal state of brain metabolites was analyzed. Results: compared with the control group, the fractional low frequency oscillation amplitude in the default network area and cerebellar area of the patients in the MHE and OHE groups was significantly lower than that in the control group, and in the middle temporal gyrus. The fractional low frequency oscillation amplitude of middle frontal gyrus and paraventricular leukoplasm was significantly increased. The Cho/Cr and mI/Cr of MHE group were significantly higher than those of OHE group (P 0.05) and OHE group (1.93 卤0.152.03 卤0.22, respectively). There was no significant difference between MHE group and OHE group (P < 0.51). The product ratio was significantly lower than that in the normal control group (NAA/Cr 2.78 卤0.19) (P 0.05). Conclusion the lower amplitude of low-frequency oscillation in rest default network area and cerebellar area is, the more serious the structure of the middle temporal gyrus is, the more serious it is, the lower the amplitude of oscillation is. The lower the ratio of subpeak area of brain metabolites in patients with HE, the more serious the disease is, which provides a reference for diagnosis and treatment.
【作者单位】：甘肃省兰州市第二人民医院医学影像科;
【基金】：兰州市人才创新创业科技计划项目(2015-RC-56)
【分类号】：R445.2;R747.9

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