3D-ASL技术对急诊科青年医师睡眠剥夺前后脑血流灌注变化的研究

The research of emergency department young physicians' cerebral blood flow changes before and after sleep deprivation using a MR 3D-ASL technology

目的探讨急诊科青年医师睡眠剥夺(SD)前后全脑灌注分布的特点。方法收集经磁共振头颅动脉成像(MRA)、常规MR检查筛选的急诊科青年医师以及正常对照组各15例,SD前后采用自身对照设计。在正常觉醒期和睡眠剥夺24 h后分别于上午8时进行2次三维动脉自旋标记技术(3D-ASL)扫描;正常对照组在保证前1 d晚上睡眠超过8 h的条件下,于上午8时行3D-ASL检查,另外使用FMRI及Spm 8软件进行图像及数据处理。结果 SD前后对比显示,灌注升高区主要位于双侧前额叶、右侧颞叶及顶叶、右后扣带回、右侧丘脑、脑干及右侧梭状回(P<0.05);灌注减低区主要位于双侧岛叶、双侧基底节区及左侧额中回,差异有统计学意义(P<0.05)。睡眠剥夺后与正常对照组对比较,灌注升高区主要位于双侧额叶、右侧颞叶及顶叶、双侧丘脑、脑干及左侧梭状回(P<0.05);而灌注减低区主要位于双侧岛叶、双侧枕叶及左侧额中回、半卵园中心,差异有统计学意义(P<0.05)。结论 3D-ASL能间接地反映长期睡眠剥夺对急诊科青年医师的认知、情绪、执行及记忆等神经功能的影响,对临床寻求针对性方案有一定的指导意义。

Objective To discuss the distribution characteristics of cerebral blood flow perfusion before and after sleep depriva- tion（SD） in the young physician of emergency department. Method Thirty young doctors of emergency department and normal volun- teers were collected by the magnetic resonance cranial artery imaging（MRA） and routine MR examination. Using a self - control design for before and after sleep deprivation,sleep deprivation group was implemented throuh two 3D -ASL scanning at 8：00 am between the normal waking and sleep - deprivation after twenty - four hours. The normal group with the condition of ensuring last evening sleep more than eight hours was implemented by the 3 D - ASL checking at 8：00 am In addition, the date and imaging were performed by FMRI func- tion software and Spm8 software. Results The comparison before and after SD show：rise area were mainly in bilateral frontal lobe, right temporal lobe and parietal lobe, right posterior cingulate, right thalamus, the brain stem, and the right fusiform gyrus （ P 〈 0.05 ） ; Reduced perfusion area mainly in bilateral insula, bilateral basal ganglia, the left frontal, the difference was statistically significant （ P 〈 0.05 ）. Comparing SD with normal control group：the high perfusion area mainly in bilateral frontal lobe, right temporal lobe and parietal lobe, bi- lateral basal ganglia and thalamus （ P 〈 0.05 ）, the brain stem and the left fusiform gyrus ; the Decreased perfusion area mainly in bilateral insula, bilateral occipital lobe and back to the left frontal, half egg circle center, the difference was statistically significant （P 〈 0.05 ）. Conclusion 3D - ASL can be indirectly reflected chronic sleep deprivation in the emergence department of young doctors＇ cognition,e- motion, execution and memory effect of nerve functionthat has certain guiding significance to clinical for seeking the scheme of targeted.