高血压合并代谢异常脑磁共振弥散张量成像研究

Study on Cerebral Magnetic Resonance Diffusion Tensor Imaging of Hypertension Complicated with Metabolic Disorder

【目的】探讨磁共振弥散张量成像（DTI）检测对病程5年以上高血压患者早期隐匿性脑神经纤维微结构损害的诊断价值。【方法】本院诊治的高血压患者12例为病例组，健康体检者17例为对照组。检查其一般项目（身高、体重、血压、血糖、血脂、认知等神经功能相关量表评分），并进行头颅MRI及DTI检查，将所测得结果进行比较分析。【结果】①高血压组内囊后支及放射冠区各向异性（FA）值均明显低于对照组，且差异有显著性（均P〈0．05）。②以高血压为自变量，FA值为因变量，多元回归分析结果显示：FA值与高血压年限呈负相关（r=-0．127，P〈o．05）。【结论】①高血压病程5年以上者脑部神经纤维微结构已有损害。②患者神经纤维损害严重程度与高血压年限明显相关。③高血压是脑神经纤维微结构损害的独立危险因素。

[Objective] To explore the value of magnetic resonance diffusion tensor imaging（DTI） for the diagnosis of early latent damage of nerve fiber structure in hypertensive patients with the course longer than 5 years. [Methods] Twelve patients with hypertension diagnosed and treated in our hospital were chosen as case group, and 17 healthy subjects were chosen as control group. The general data（body height, weight, blood pressure, blood glucose, blood lipid and nerve function scale such as cognition） were examined. Cerebral mag- netic resonance image（MRI） and DTI were performed. The results were compared and analyzed. [Results] Anisotropy（FA） values of posterior limb of internal capsule（PLIC） and corona radiate area（CRA） in hyperten- sion group were obviously lower than those in control group, and there was significant difference（ P d0.05）. Hypertension was independent variable and FA value was dependent variable. Multiple logistic analysis results showed that FA values was negatively associated with the course of hypertension（r=--0. 127, P d0.05）. [Conclusion]The damage of nerve fiber structure in brain of hypertensive patients with the course longer than 5 years is observed. The severity of nerve fiber in brain is related to the course of hypertension. Hypertension is an independent risk factor of nerve fiber structure damage.