慢性阻塞性肺疾病患者脑白质微结构变化的初步研究

Changes of white matter microstructure in patients with chronic obstructive pulmonary disease

目的:采用基于白质纤维束空间统计分析(tract based spatial statistics,TBSS)的方法研究慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者全脑白质纤维束微观结构变化。方法:选取30例稳定期COPD患者和30例性别、年龄及教育程度匹配的健康志愿者(对照组),应用3.0 T磁共振进行全脑DTI(diffusion tensor imaging)序列扫描。采用TBSS方法对2组被试全脑白质纤维束的部分各向异性指数(fractional anisotropy,FA)、平均弥散率(mean diffusivity,MD)进行基于体素的全脑非参数统计学比较。结果:与正常对照组相比,COPD组的胼胝体、双侧丘脑前辐射、皮质脊髓束、左侧额枕下束、左侧上纵束FA值明显下降(P<0.05,TFCE校正);胼胝体、双侧额枕下束、右侧丘脑前辐射、左侧钩束MD值明显升高(P<0.05,TFCE校正)。结论:相对于正常对照组,COPD患者大脑白质纤维束出现多发微观损伤,其DTI多参数改变提示与认知损伤、情绪调节相关的脑白质纤维髓鞘结构完整性发生退变。

Objective：To explore changes of white matter microstructure in patients with chronic obstructive pulmonary disease（COPD）via the tract-based spatial statistics（TBSS）.Methods：Diffusion Tensor Imaging（DTI）was used in the experimental group of stable non-hypoxemic patients with COPD（n=30）and the control group of volunteers with same age,gender and education background（n=30）.TBSS was used to compare the nonparametric statistics of fractional anisotropy（FA）and mean diffusion（MD）in both groups.Results：Compared with those in control group,FA including the corpus callosum,bilateral anterior thalamic radiations,the corticospinal tract,left inferior fronto-occipital fasciculus and left superior longitudinal fasciculus in the experimental group were significantly decreased（P〈0.05,TFCE correction）.Meanwhile,MD including corpus callosum,bilateral inferior fronto-occipital fasciculus,right anterior thalamic radiation and left unciform fasciculus were significantly increased（P〈0.05,TFCE correction）.Conclusion：It is showed that COPD patients have multiple microstructural injuries in the white matter fiber tracts.The results of DTI multiple diffusion parameters indicate degenerative changes of brain white matter fiber tracts which is related to cognitive impairment and emotion regulation.