无症状反流性食管炎患者静息期脑区活性特征分析

Charecteristics of the activity in brain resting regions of patients with asymptomatic reflux esophagitis

目的 观察无症状反流性食管炎（RE）患者静息期全脑的活性特征,初步探讨默认网络在无症状RE发病机制中的作用.方法 对15例无症状RE患者、15例有症状RE患者和15名健康志愿者（健康对照组）行无任务刺激静息态下脑功能磁共振成像（fMRI）扫描,采用比率低频振荡振幅（fALFF）方法,比较和分析无症状RE患者、有症状RE患者和健康对照组fALFF增强和减弱区域特征.应用SPM 5软件进行数据预处理.单样本t检验分别观察各组静息态显著活性区域,双样本t检验观察比较无症状RE组与健康对照组及有症状RE组全脑活性区域特点.结果 健康对照组及无症状RE患者、有症状RE患者在静息期活性脑区基本相似,内脏感觉处理相关网络内仅小部分脑区活性发生改变.无症状RE患者静息期默认网络内活性脑区与健康对照组差异无统计学意义；与有症状RE患者相比,右侧中央沟盖、右侧颞上回、右侧脑岛、右侧颞横回、右侧中央后回、颞极和颞上回fALFF减低[峰值点坐标（X,Y,Z）为（50,-6,1 2）,t=2.7874,P＜0.01].结论 静息期默认网络活性特征的差异可能在无症状性RE患者发病机制中发挥重要的作用.

Objective To observe characteristics of the activity in resting brain of asymptomatic reflux esophagitis （RE） patients, and explore the role of default network in the pathogenesis of asymptomatic RE. Methods Functional magnetic resonance imaging （fMRI） was performed to scan the brains of 15 asymptomatic RE patients, 15 symptomatic RE patients and 15 healthy volunteers under no-mission-stimulation state. With fractional amplitude of low frequency fluctuation （fALFF）, characteristics of the strengthened and weakened regions of asymptomatic RE patients, symptomatic RE patients and healthy individuals were compared and analyzed. SPM 5 was applied for data preprocessing. Single-sample t test was performed to observe the noticeable active regions of each group under resting state, and then double-sample t test was used to compare the characteristics of active regions of the entire brain between asymptomatic RE patients and symptomatic RE patients or healthy individuals. Results Under resting state, the active brain regions of asymptomatic RE patients, symptomatic RE patients and healthy individuals were similar. The activity of only small partof brain regions in visceral sensory processing relevant networks changed. There was no significant difference＇in the active regions of default network under resting state between asymptomatic RE patients and healthy individuals. Compared with symptomatic RE patients, fALEF decreased at right central sulcus cover, right superior temporal gyrus, right insula, right transverse temporal gyrus, right postcentral gyrus, superior temporal gyrus and temporal pole （X=50,Y=-6,Z=12, t= 2. 7874,P〈0.01）. Conclusion The difference in characteristics of activity in default network under resting state may play an important role in the pathogenesis of asymptomatic RE.