[1]高 林,闵连秋△.磁共振质子波谱成像在卒中后认知障碍研究中的应用*[J].陕西医学杂志,2020,49(7):792-795799.[doi:DOI:10.3969/j.issn.10007377.2020.07.006]
　GAO Lin,MIN Lianqiu..Clinical significance of proton magnetic resonance spectroscopy in the study of cognitive impairment after stroke[J].,2020,49(7):792-795799.[doi:DOI:10.3969/j.issn.10007377.2020.07.006]
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磁共振质子波谱成像在卒中后认知障碍研究中的应用*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年7期
页码:
792-795799
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Clinical significance of proton magnetic resonance spectroscopy in the study of cognitive impairment after stroke
作者:
高 林1; 2; 闵连秋1△
1.锦州医科大学附属第一医院神经内科(锦州 121000); 2.辽宁省健康产业集团抚矿总医院神经内科(抚顺 113006)
Author(s):
GAO Lin; MIN Lianqiu.
Department of Neurology,the First Affiliated Hospital of Jinzhou Medical University(Jinzhou 121000)
关键词:
磁共振质子波谱成像;  卒中;  认知障碍;  简易智能精神状态检查量表;  蒙特利尔认知评估量表
Keywords:
Proton magnetic resonance spectroscopy;  Stroke;  Cognitive impairment;  MMSE scale;  MOCA scale
分类号:
R743.3
DOI:
DOI:10.3969/j.issn.10007377.2020.07.006
文献标志码:
A
摘要:
目的:采用磁共振质子波谱成像(1H-MRS)技术,研究卒中后认知障碍(PSCI)患者脑内代谢物质含量的变化及其与认知损害程度的相关性,探讨其临床应用价值。方法:收集80例卒中患者,根据简易智能精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MOCA)评分结果分为卒中后认知障碍组(PSCI组)30例,卒中后认知功能正常组(NCI组)50例。收集同期健康体检的志愿者20例作为正常对照组(NOR组)。对各组病例进行1H-MRS检查,计算双侧额叶白质N-乙酰天门冬氨酸盐(NAA)/肌酸(Cr)、胆碱复合物(Cho)/肌酸(Cr)、肌醇(MI)/肌酸(Cr)及肌醇(MI)/N-乙酰天门冬氨酸盐(NAA)的比值,并进行统计分析。结果:PSCI组左侧、右侧的NAA/Cr值显著低于NCI组和NOR组(P<0.05),MI/Cr、MI/NAA值均大于NCI组和NOR组(P<0.05)。PSCI组和NCI组Cho/Cr值比较差异无统计学意义(P>0.05),但两组指标均与NOR组的Cho/Cr值比较,差异具有统计学意义(P<0.05)。PSCI组NAA/Cr值与MMSE、MOCA评分存在正相关性,MI/Cr、MI/NAA值与MMSE、MOCA评分存在负相关性(P<0.05),而Cho/Cr值与MMSE、MOCA评分不存在相关性(P>0.05)。结论:1H-MRS检查可反映PSCI患者脑内代谢物变化,有利于实现疾病早期、无创、准确和全面的评估。
Abstract:
Objective:To study the changes of cerebral metabolites in patients with post-stroke cognitive impairment(PSCI)by proton magnetic resonance spectroscopy(1H-MRS)and its correlation with the degree of cognitive impairment,and to explore its clinical application value. Methods:80 stroke patients were collected and divided into PSCI group(30 cases)and NCI group(50 cases)according to the results of Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MOCA). 20 healthy volunteers who underwent physical examination during the same period were collected as the normal control group(NOR group). Each group was examined by 1H-MRS,and the ratio of N-acetyl aspartic acid(NAA)/creatine(Cr),choline complex(Cho)/Cr,inositol(MI)/ Cr and MI/NAA in bilateral frontal white matter was calculated and analyzed. Results:The NAA/Cr values of the left and right sides in the PSCI group were significantly lower than those in the NCI group and NOR group(P<0.05),and the MI/Cr and MI/NAA values were both higher than those in the NCI group and NOR group(P<0.05). There was no significant difference in Cho/Cr value between the PSCI group and the NCI group(P>0.05),but there was significant difference in Cho/Cr value between the two groups and NOR group(P<0.05). In the PSCI group,NAA/Cr value was positively correlated with MMSE and MOCA scores,MI/Cr and MI/NAA values were negatively correlated with MMSE and MOCA scores(P<0.05),while Cho/Cr value was not correlated with MMSE and MOCA scores(P>0.05). Conclusion:The 1H-MRS examination can reflect the changes of metabolites in the brain of PSCI patients,which is conducive to the early,non-invasive,accurate and comprehensive evaluation of the disease.

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备注/Memo

备注/Memo:
*辽宁省自然科学基金资助项目(20170540379)
更新日期/Last Update: 2020-07-28