3.0T磁共振SWI在2型糖尿病脑微出血与认知功能影响的临床研究

3.0T MRI SWI clinical study of cerebral microbleeds in type 2 diabetes and association with cognitive function

目的:以脑微出血作为生物学标志物研究2型糖尿病脑病微血管病变,并探讨其在糖尿病认知功能障碍发生中的影响。方法:收集认知功能障碍的2型糖尿病患者30例,及年龄、性别及受教育程度相匹配的无认知功能障碍的2型糖尿病患者30例。记录每位受测试者的Mo CA评分总分及各项分值等分。采用SWI扫描记录两组脑微出血(CMBs)灶的分布及数量。结果:在所有57例中发现CMBs病26例,CMBs患病率为45.6%。共发现CMBs灶155个,出血数目及分布以皮层/皮层下区多见,皮层/皮层下区CMBs共有107个,大脑半球深部CMBs 41个,脑干及幕下CMBs 7个,占总数分别为69.0%、26.5%、4.5%。两组CMBs灶发生例数及个数有统计学差异(P<0.05)。两组CMBs灶在皮层-皮层下区、大脑半球深部发生例数有统计学差异(P<0.05)。CMBs与Mo CA总分、视空间执行能力、注意力、语言能力、抽象能力、记忆力评分呈负相关(P<0.05);而与命名能力及定向力评分无相关性(P>0.05)。结论:脑微出血是影响糖尿病患者认知功能的一个独立因素,并且有随CMBs数目增多,认知功能损害越重的趋势。

Objective： To study type 2 diabetic encephalopathy microvascular disease by SWI with cerebral microbleeds （CMBs） as biological markers, and explore the impact of cognitive dysfunction in diabetes. Methods： We recruit patients with type 2 diabetes with cognitive dysfunction by montreal cognitive scale （MoCA） in 30 cases, and patients with type 2 diabetes, having non-recognition dysfunction in 30 cases, which matched by age, sex and education level. Each subject＇s MoCA total score and the specific score were recorded, then underwent conventional MRI and SWI scan. The number and location of CMBs on SWI images of two groups were examined. Results： In all 57 cases, 26 cases had CMBs, CMBs prevalence was 45.6%. There were 155 GMBs, the number and distribution of CMBs were common in subcortical/cortical areas, there were 107 CMBs at subcortical/cortical areas, lower hemisphere deep CMBs were 41, brainstem and curtain CMBs were 7, account- ing for the total respectively 69.0%, 26.5%, 4.5%. The two groups had significant difference in the number and case of CMBs （P〈0.05）. The two groups had significant difference in the case of CMBs in difference area of brain （P〈0.05）. According to Spearman correlation analysis results, the CMBs number was negatively correlated with total MoCA scores, visuospatial skills and execution function scores, attention scores, language scores, abstracting scores and memory scores （P〈0.05）. Conclusion： CMBs is an independent factors affecting cognitive function in diabetic patients, and there is a trend that with an increase of the number of CMBs, it leads the more severe cognitive impairment.