2型糖尿病患者听皮层区磁共振氢质子波谱分析

发布时间：2018-04-11 16:14

本文选题：型糖尿病 + 听皮层　；参考：《听力学及言语疾病杂志》2015年02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2型糖尿病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糖尿病患者98例,根据纯音听阈将其分为糖尿病并双侧耳聋组(32例)、糖尿病并单侧耳聋组(18例)、单纯糖尿病组(48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,根据神经代谢产物其峰下面积计算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;对血糖值与各神经代谢产物的相关性进行Pearson相关分析,根据ROC曲线面积判定上述各指标诊断早期糖尿病并感音神经性听力损失的灵敏度及特异度。结果糖尿病患者空腹血糖值与NAA/Cr、NAA/Cho呈负相关(P0.05),与Cho/Cr、mI/Cr呈正相关(P0.05);与正常对照组相比,单纯糖尿病组听皮层神经代谢产物NAA/Cho、NAA/Cr降低(P0.05),Cho/Cr、mI/Cr升高;糖尿病合并双侧耳聋组NAA/Cho降低(P0.05),Cho/Cr升高;糖尿病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(P0.05)。NAA/Cho的ROC曲线下面积为81%,准确性较高,且当NAA/Cho为1.65时可以作为单纯糖尿病与糖尿病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指标NAA/Cho有可能作为判定糖尿病人群发生感音神经性聋的早期听皮层代谢预警指标。
[Abstract]:Objective to investigate the early warning effect of 1H magnetic resonance spectroscopy1 H-MRS technique on nerve cell injury in auditory cortex of type 2 diabetic patients.Methods Ninety-eight patients with diabetes mellitus were randomly selected and divided into three groups according to pure tone hearing threshold: 32 patients with diabetes mellitus with bilateral deafness, 18 patients with diabetes mellitus with unilateral deafness, 48 patients with diabetes mellitus, and 15 healthy volunteers as control group.The correlation between blood glucose and neurometabolites was analyzed by Pearson.According to the area of ROC curve, the sensitivity and specificity of the above indexes in the diagnosis of early diabetes mellitus and sensorineural hearing loss were determined.In diabetic patients with unilateral deafness, both the NAA/Cho of the affected side and the healthy side were decreased, and the area under the ROC curve of the NAA/Cho in the affected side was lower than that in the healthy side, and the area under the ROC curve was 81. The accuracy was higher than that in the normal side.When NAA/Cho was 1. 65, it could be used as a dividing line between diabetes mellitus and diabetic patients with sensorineural deafness. The area under the ROC curve of other nerve metabolites was 50.Conclusion NAA/Cho may be used as an early warning index of auditory cortex metabolism in diabetic patients with sensorineural deafness.
【作者单位】：河北医科大学第一医院耳鼻咽喉头颈外科;河北省石家庄市正定县人民医院;
【基金】：河北省高等学校科学技术研究重点项目(ZH2011220) 河北省科学技术研究与发展计划项目(12276103D)联合资助
【分类号】：R587.1;R764

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