老年痴呆患者海马代谢的磁共振波谱分析

Analysis on the metabolism of hippocampus in aging dementia with magnetic resonance spectroscopy

目的探讨利用氢质子磁共振波谱技术研究老年痴呆患者海马代谢变化的临床意义。方法入组者均符合老年痴呆的诊断标准,并排除其他因素引起的痴呆及混合性痴呆,同时选择年龄、性别相匹配的健康志愿者作为正常对照组分别进行常规MRI和磁共振波谱检查,获得双侧海马区N-乙酰天冬氨酸/肌酸、胆碱化合物/肌酸和肌醇/肌酸比值,进行统计学分析。结果正常对照组双侧海马区N-乙酰天冬氨酸/肌酸、胆碱化合物/肌酸和肌醇/肌酸比值差异无统计学意义(均P>0.05)。老年痴呆组患者左侧海马区肌醇/肌酸比值高于右侧(P<0.01),且均高于正常对照组(P左<0.01,P右<0.05),左侧N-乙酰天冬氨酸/肌酸比值低于右侧(P<0.05),且均低于正常对照组(P左<0.01,P右<0.01)。但胆碱复合物/肌酸比值差异无统计学意义(均P>0.05)。结论氢质子磁共振波谱成像可显示老年痴呆患者海马的代谢改变,有助于老年痴呆发生风险的预测。

Objective To evaluate the utility of the hydrogen proton magnetic resonance spectmscopy （IH MRS） for investigating metabolic changes of the hippoeampus in patients with Alzheimer disease. Methods Diagnosed patients with Alzheimer and criteria and age and sex matched healthy controls were admitted. After magnetic resonance imaging （MRI） examination and neuropsychological tests,magnetic resonance spectroscopy （MRS） were performed in patients and controls. The ratio of N-acetylaspartic acid （NAA）/creatine （Cr）, choline compound （Cho）/Cr and myo-inositol （mI）/Cr in bilateral hippoeampus region were assessed. The results were analysed statistically. Results The results of the ratios of NAA/Cr, Cho/Cr and mI/Cr showed no significant differences in bilateral hippocampus region of controls （ P 〉 0. 05, for all）. AD the left hippoeampus of patients myo-inositol/creatine ratio is higher than the right side （P 〈 0.05 ） , and were higher than the normal control group （ P 〈 0. 01, P 〈 0. 05 ） , N-acetylaspartic acid/creatine ratio on the left side, and were lower than the control group （P 〈 0. 01, P 〈 0. 01 ）, However, choline eompounds/creatine ratio difference was not statistically significant （ P 〉 0.05, all ）. Conclusions MRS imaging can detect metabolic changes of the hippocampus in Alzheimer disease patients. It is helpful for predicting the risk of dementia.