阿尔茨海默病患者弥散峰度成像参数与认知功能、细胞因子分泌的相关性

The correlation of diffusional kurtosis imaging parameters with cognitive function and cytokine secretion in patients with Alzheimer's disease

目的检测阿尔茨海默病(AD)患者的弥散峰度成像(DKI)参数值,评估DKI参数值与患者认知功能、血清神经损伤指标水平的内在联系。方法2015年12月至2018年1月间在首都医科大学宣武医院首诊的AD患者78例作为AD组,同期在本院进行体检的健康志愿者50例作为正常对照组。对比两组研究对象的胼胝体DKI参数[弥散峰度(MK)、轴向峰度(AK)、径向峰度(RK)]水平,简易精神状态评价量表(MMSE)评分值及血清神经损伤指标[β淀粉样蛋白1-42(Aβ1-42)、S100B蛋白(S100B)、脑源性神经营养因子(BDNF)]水平,采用Pearson检验评估AD患者DKI参数与MMSE评分值及血清神经损伤指标含量的相关性。结果AD组患者MK、AK、RK的水平低于正常对照组;MMSE评分值低于正常对照组;血清中Aβ1-42、S100B水平高于正常对照组,BDNF水平低于正常对照组(P<0.05)。相关性分析发现,AD患者的MK、AK、RK水平与MMSE评分值及Aβ1-42、S100B、BDNF含量均相关(P<0.05)。结论AD患者胼胝体DKI参数水平异常降低,具体水平与认知功能及神经损伤严重程度密切相关,可能是早期评估AD病情的有效手段之一。

Objective To detect the diffusional kurtosis imaging(DKI)parameters of patients with Alzheimer's disease(AD),and evaluate the inner link of DKI parameters with cognitive function and serum nerve injury index.Methods 78 patients who were first diagnosed with AD in our hospital between December 2015 and January 2018 were enrolled in AD group,and 50 healthy volunteers who had physical examination in our hospital during the same period were enrolled in normal control group.The corpus callosum DKI parameters[mean kurtosis(MK),axial kurtosis(AK)and radial kurtosis(RK)]values,Mini-Mental State Examination(MMSE)score as well as serum nerve damage indexes[βamyloid 1-42(Aβ1-422),S100B protein(S100B)and brain-derived neurotrophic factor(BDNF)]were compared between the two groups of subjects.Pearson test was used to evaluate the correlation of DKI parameters with MMSE score as well as serum nerve injury index in patients with AD.Results MK,AK and RK levels in AD group were lower than those in normal control group;MMSE score was lower than that of normal control group;serum Aβ1-42 and S100B contents were higher than those of normal control group while BDNF content was lower than that of normal control group(P<0.05).Correlation analysis revealed that the MK,AK and RK values in AD patients were directly correlated with the MMSE score as well as Aβ1-42,S100B and BDNF levels(P<0.05).Conclusions The corpus callosum DKI parameter levels decrease in AD patients,and the specific levels are closely related to the severity of cognitive function and nerve injury,which may be one of the effective methods for early assessment of AD condition.