氢质子磁共振波谱技术检测一氧化碳中毒迟发性脑病海马代谢产物

Magnetic resonance spectroscopy in assessing metabolism of hippocampus in patients with delayed encephalopathy after acute carbon monoxide poisoning

目的采用1 H-MRS评价一氧化碳中毒后迟发性脑病(DEACMP)患者海马代谢产物的变化。方法纳入43例DEACMP患者(DEACMP组)和30名健康志愿者(对照组),两组研究对象按年龄分年轻亚组(<50岁)和年老亚组(≥50岁)。对所有研究对象进行双侧海马区1 H-MRS扫描,采用单体素分辨自旋回波序列的点解析波谱法采集数据,检测双侧海马区N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)值,采用独立样本t检验比较组间数据差异。结果对照组与DEACMP组左右两侧海马NAA/Cr、Cho/Cr差异均无统计学意义(P均>0.05)。同一年龄亚组DEACMP组NAA/Cr均低于对照组,Cho/Cr均高于对照组,差异有统计学意义(P均<0.05)。结论 1 H-MRS可检测DEACMP患者海马区代谢产物的变化,对早期诊断及评估病情具有重要意义。

Objective To assess the changes of hippocampus metabolites in delayed encephalopathy after acute carbon monoxide poisoning （DEACMP） using 1H-MRS. Methods Totally 43 DEACMP patients （DEACMP group） and 30 healthy volunteers （control group） were recruited, and subjects in both groups were further divided into young （〈50 years old） and aged subgroup （≥50 years old）. All subjects underwent 1H-MRS scanning of bilateral hippocampus. 2D-1H-MRS point-resolved spectroscopy was performed to obtain N-acetylaspartic acid/creatine （NAA/Cr） and choline/creatine （Cho/Cr）. The data was then analyzed with t-test. Results There were no significant differences between left and right hippocampus in both groups （all P〉0.05）. In both young and aged subgroups, NAA/Cr of DEACMP patients decreased and Cho/Cr increased compared with controls （all P〈0.05）. Conclusion 1H-MRS can detect metabolites changes in hippocampus of patients with DEACMP, which has important significance in early diagnosis and assessment of DEACMP.