男性痛风合并轻度认知功能障碍患者海马MR扩散张量成像的定量分析

Quantitative analysis of hippocampus diffusion tensor imaging in male gout patients with mild cognitive impairment

目的探讨海马区DTI在男性痛风合并轻度认知功能障碍(MCI)患者中的应用价值。方法病例组纳入男性痛风患者35例,其中痛风合并MCI(gout-MCI)亚组15例,痛风合并认知功能正常(gout-CN)亚组20例,记录病例组患者最高血尿酸水平及近5年平均血尿酸水平。另选取15名健康志愿者作为正常对照组。对所有受检者行简明精神状态检查量表(MMSE)及蒙特利尔认知评估量表(MoCA)评分后,行常规颅脑MR和DTI检查,测量并记录FA、ADC值,并进行统计学分析。结果 gout-MCI亚组患者近5年平均血尿酸水平低于gout-CN组患者(P<0.05)。gout-MCI亚组患者海马FA值低于gout-CN亚组及正常对照组(P<0.05),gout-MCI亚组患者海马ADC值高于gout-CN组及正常对照组(P<0.05)。gout-CN亚组患者海马FA值、ADC值与正常对照组差异无统计学意义(P>0.05)。gout-MCI亚组患者海马FA值与MoCA评分呈正相关(P<0.05),与MMSE评分无相关性,右侧海马ADC值与MoCA评分呈负相关(P=0.04)。结论颅脑DTI技术可早期检测痛风合并MCI患者双侧海马的损伤。

Objective To analyze the application value of hippocampus MR diffusion tensor imaging （DTI） in male gout patients with mild cognitive impairment （MCI）. Methods Thirty-five male gout patients were enrolled, including 15 gout patients with mild cognitive impairment （gout-MCI subgroup） and 20 gout patients with cognition normal （gout-CN subgroup） ; both maximum and average values of serum uric acid concentration over the past 5 years were recorded. Fifteen healthy controls were recruited as control group. Conventional MRI and DTI were performed for all subjects following mini-mental state examination （MMSE） and montreal cognitive assessment （MoCA） evaluation. FA and ADC were measured on the work station. Statistical analysis was per- formed. Results The average value of serum uric acid concentration of gout-MCI subgroup was lower than that of gout-CN sub- group （P〈0. 05）. The FA value in gout-MCI subgroup was lower than that in gout-CN subgroup and control group （P〈0.05）. The ADC value in gout-MCI subgroup was higher than that in gout-CN subgroup and control group （P〈0.05）. Both FA and ADC value in gout-CN subgroup had no statistical difference compared with those in control group. The FA value in gout-MCI subgroup had positive correlation with MoCA scores （P〈0.05）, had no correlation with MMSE scores （P〈0.05）. The ADC value of right hippocampus had negative correlation with MoCA score （P=0. 04）. Conclusion MR DTI can early detect mild im- pairment of hippocampus in gout patients with MCI.