阻塞性睡眠呼吸暂停综合征病人脑损害的MRS研究

Brain metabolic impairment in OSAS:evidence from MRS

目的探讨MRS在阻塞性睡眠呼吸暂停综合征(OSAS)中的应用价值。方法应用1.5T超导型MR设备对21例重度、14例轻中度OSAS病人及性别、年龄相匹配的15例健康对照者的双侧额叶及左侧颞-顶-枕叶交界区、左侧海马行单体素氢质子波谱——点分辨自旋回波波谱序列扫描。结果①左侧额叶NAA/Cr,OSAS重度组明显小于健康对照组(P=0.004);右侧额叶NAA/Cr,轻中度组(P=0.007)及重度组(P=0.002)均小于健康对照组;左侧海马NAA/Cr,OSAS病例组较健康对照组有减小的趋势。②右侧额叶mI/Cr,OSAS轻中度组(P=0.000)及重度组(P=0.008)均大于健康对照组。③左侧额叶Glx/Cr,OSAS重度组明显小于健康对照组(P=0.006);右侧额叶Glx/Cr,OSAS重度组较健康对照组有减小的趋势。结论 MRS分析显示OSAS易累及双侧额叶。MRS可以从代谢水平上评价OSAS的脑损害。

Objective To evaluate the impact of obstructive sleep apnea syndrome（OSAS） on human cerebral metabolism by using magnetic resonance spectroscopy（MRS）.Materials and methods Twenty-one severe OSAS patients,14 mild-moderate OSAS patients,and 15 healthy control subjects were included.All subjects underwent MRS using the point-resolved echo spin spectroscopy（PRESS）.Proton volumes of interest were placed in the bilateral frontal lobes and left temporal-parietal-occipital cortex,and left hippocampus.Results 1.Compared to the controls,the NAA/Cr ratio was significantly decreased in the left frontal lobe in the severe OSAS group（P=0.004）,and in the right frontal lobe in the severe（P=0.002）and mild-moderate（P=0.007） OSAS patients.The NAA/Cr ratio trended to be decreased in the left hippocampus in the OSAS patients compared to controls.2.A significant increase in the mI/Cr ratio was detetcted in the right frontal regions in the severe（P=0.008） and mild-moderate（P0.001） OSAS groups.3.Glx/Cr ratio values were significantly smaller than controls in the left（P=0.006） and right（P=0.027） frontal regions.Conclusion Bilatoral frontal lobes are the vulnerable location in patients with OSAS.MRS can be used to screen the brain metabolic impairment.