减肥手术对肥胖患者大脑结构损伤修复机制的研究

发布时间：2018-05-27 09:13

本文选题：肥胖 + 手术减肥　；参考：《西安电子科技大学》2015年硕士论文

【摘要】：随着我国经济的飞速发展,人民生活水平的不断提高,饮食结构发生了巨大改变,高热量、低纤维食物成为主流。此外,人们劳动和运动量的减少,均导致了能量摄入和消耗的不平衡,进而造成我国肥胖人口迅速的上升。我国目前总人口数量成为继美国之后的全球第二大国,这些都给人民健康造成严重损伤,同时也给社会经济的发展和社会的进步带来阻碍。针对肥胖的影像学研究表明,肥胖造成大脑结构的损伤和功能的改变,主要集中在负责饮食控制和情绪调节的区域。针对肥胖的干预治疗表明,在众多的肥胖治疗方法中,以袖套式胃(LSG)减肥手术等为主的外科手术成为治疗肥胖长期有效的方式。研究表明手术减肥在减轻体重的同时,通过脑肠互动调节大脑负责饮食控制和情绪控制区域,使肥胖患者大脑功能得到改善。但是减肥手术是否能够修复或者逆转肥胖造成的大脑结构损伤,目前还没有研究报道。本研究中借助功能磁共振3D成像技术,选择肥胖被试和正常人,对肥胖被试跟踪随访,获得肥胖被试术前术后和正常人3D结构像。一方面,采用T1加权3D结构像研究手术前后大脑结构的变化,主要包括大脑灰质、白质密度,皮层表面积、体积、厚度；另一方面,结合图论方法,研究手术减肥对大脑拓扑结构的影响。结果表明,1)肥胖造成大脑负责饮食控制和认知情绪调节区域灰白质密度、皮层厚度的降低,皮层体积和表面积的增加；手术减肥增加了灰白质密度、皮层厚度,降低了皮层体积和表面积,修复了肥胖造成的损伤。2)肥胖造成大脑拓扑结构稳定性降低,使大脑各区域之间相互制约性降低,手术减肥后大脑拓扑稳定性增强,各大脑区域之间相互制约性加强,这就使大脑关于驱动和控制等脑区活动趋于正常。总之,长期肥胖会导致患者大脑结构异常,同时手术减肥起到一定的神经修复作用恢复,逆转了肥胖造成的损伤。这些研究结果,为揭示手术减肥的脑肠互动作用机制提供了一些影像学证据。同时为其他大脑结构损伤类疾病的治疗提供了一种技术手段。
[Abstract]:With the rapid development of economy and the improvement of people's living standard, the diet structure has changed greatly, and high calorie and low fiber food have become the mainstream. In addition, the decrease of labor and exercise leads to the imbalance of energy intake and consumption, which leads to the rapid increase of obesity population in China. At present, the total population of our country has become the second largest country in the world after the United States, which has caused serious damage to the health of the people, at the same time, it has also hindered the development of social economy and social progress. Imaging studies on obesity show that obesity causes damage to brain structure and changes in function, mainly in areas responsible for diet control and emotional regulation. The intervention therapy for obesity has shown that among the many obesity treatment methods, the surgical operation, such as sleeve stomach LSG-based weight-loss surgery, has become a long-term effective method for the treatment of obesity. The study shows that the brain function of obese patients can be improved by adjusting the brain responsible for diet control and emotional control through the interaction between brain and intestine while reducing weight by surgery. But whether weight loss surgery can repair or reverse brain damage caused by obesity has not been reported. In this study, the obese subjects and normal subjects were followed up by functional magnetic resonance 3D imaging, and 3D structural images of obese subjects and normal subjects were obtained before and after operation. On the one hand, the changes of brain structure before and after surgery were studied by using T1 weighted 3D structure image, mainly including gray matter, white matter density, cortical surface area, volume, thickness; on the other hand, the method of graph theory was used to study the changes of brain structure. To study the effect of surgical weight loss on brain topology. The results showed that obesity resulted in the density of gray matter, the decrease of cortex thickness, the increase of volume and surface area of cortex, and the increase of density of gray matter and thickness of cortex. Reducing cortical volume and surface area, repairing the damage caused by obesity. The regions of the brain strengthen each other, which makes the activities of the driving and controlling regions of the brain normal. In a word, long-term obesity will lead to abnormal brain structure, and the surgery can restore the nerve repair and reverse the damage caused by obesity. These findings provide some imaging evidence to reveal the mechanism of brain-intestinal interaction in weight loss surgery. At the same time, it provides a technique for the treatment of other brain structure damage diseases.
【学位授予单位】：西安电子科技大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.6;R589.2

【相似文献】