摘要
目的探讨多体素质子磁共振波谱(1H-MRS)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的临床应用价值。材料与方法分别对20例临床诊断为中重度OSAHS病人(病变组)及年龄、性别相匹配的20名健康志愿者(对照组)行头颅多体素1H-MRS检查,记录两组半卵圆中心区、基底节区各代谢物比值,比较两组间的差异,观察有无乳酸(Lac)峰出现。记录病人相关临床指标,包括:睡眠呼吸暂停和低通气指数(AHI)和夜间平均血氧饱和度(SpO2),并与各代谢物比值进行相关性分析。结果病变组半卵圆中心区NAA/Cr、NAA/Cho低于对照组,Cho/Cr高于对照组,差异有统计学意义(P<0.05)。基底节区NAA/Cr、NAA/Cho较对照组稍降低,Cho/Cr较对照组稍升高,差异无统计学意义(P>0.05)。两组均未检测到Lac峰。AHI与半卵圆中心区NAA/Cho呈负相关(P<0.05),SpO2与NAA/Cho呈正相关(P<0.05),而AHI和SpO2与NAA/Cr、Cho/Cr无相关性(P>0.05)。结论多体素1H-MRI能够早期发现OSAHS脑代谢改变,为临床诊治提供客观的影像学依据。
Objective To investigate the clinical value of multivoxel 1H magnetic resonance spectroscopy （1H-MRS） in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Materials and Methods 20 patients （case group） with moderate to severe clinically diagnosed OSAHS and 20 age -gender matched healthy volunteers （control group） underwent brain multivoxel 1H-MRS examinations. The ratios of brain metabolites of centrum ovale and basal ganglia were recorded respectively. Related clinical indexes, including sleep apnea and hypopnea index （AHI） and the average night-time oxygen saturation （SpO2）, were recorded. Results In region of centrum ovale, the NAA/Cho and NAA/Cr of the case group decreased and were significantly lower than that of control group （P〈0.05）. The Cho/Cr of the case group was significantly increased compared to the controls （P〉0.05）. In region of basal ganglia, the NAA/Cho, NAA/Cr, and Cho/Cr had no significantly difference between the two groups （P〈0.05）. Lactate peak was not detected in the two groups. In the region of centrum ovale, the AHI showed inverse correlation to the NAA/Cho （P〈0.05）. The SpO2 showed positive correlations to the NAA/Cho （P〉0.05）. There was no correlation between clinical indexes and NAA/Cr or Cho/Cr （P〉0.05）. Conclusion Multivoxel 1H-MRS could early detect the changes of cerebral metabolism in patients with OSAHS. It provides an objective imaging basis for the clinical diagnosis and treatment.
出处
《国际医学放射学杂志》
2010年第5期446-450,共5页
International Journal of Medical Radiology
