髓海不足型与肝肾亏虚型阿尔茨海默病患者低频振幅研究

Study of amplitude of low-frequency fluctuation in patients with Alzheimer’s disease with marrow sea insufficiency and liver-kidney deficiency

目的采用静息态脑功能磁共振成像低频振幅(amplitude of low-frequency fluctuation,ALFF)分析法比较髓海不足型与肝肾亏虚型阿尔茨海默病(Alzheimer’s disease,AD)患者的脑功能区活动存在的差异,以期为AD患者的中医辨证分型和同病异治提供影像学证据。方法选取2018年11月至2021年4月于浙江省立同德医院就诊的AD患者60例,其中髓海不足组29例,肝肾亏虚组31例,选取同期年龄相对应的健康老年人36例纳入对照组。对三组受试者分别行静息态脑功能磁共振成像扫描,应用ALFF分析法对比三组受试者脑区的ALFF值差异。结果与对照组比较,髓海不足组患者的右小脑后部、左前扣带回、右前扣带回ALFF值升高(P<0.05),肝肾亏虚组患者的右侧岛叶、左侧岛叶ALFF值升高(P<0.05)。与髓海不足组比较,肝肾亏虚组患者的右小脑后部ALFF值降低(P<0.05)。结论静息态脑功能磁共振成像ALFF分析法可为AD患者的中医辨证分型和同病异治提供影像学证据。

Objective To explore the differences of brain functional area activities between Alzheimer’s disease(AD)patients with marrow sea insufficiency and liver-kidney deficiency by resting-state cerebral functional magnetic resonance imaging with amplitude of low-frequency fluctuation(ALFF),so as to provide imaging evidence for the dialectical classification of traditional Chinese medicine and the treating same disease with different methods of AD patients.Methods A total of 60 AD patients treated in Tongde Hospital of Zhejiang Province from November 2018 to April 2021 were selected,including 29 cases in marrow sea insufficiency group,31 cases in liver-kidney deficiency group,and 36 healthy elderly patients with corresponding age during the same period were selected to be included in control group.Three groups of subjects were scanned by resting-state cerebral functional magnetic resonance imaging,and ALFF analysis was used to compare the different brain regions of three groups of subjects.Results Compared with control group,the ALFF value in the left and right anterior cingulate gyrus and the right posterior cerebellum of marrow sea insufficiency group increased(P<0.05),the ALFF value in the left and right insular lobes of liver-kidney deficiency group increased(P<0.05).Compared with marrow sea insufficiency group,the ALFF value in the right posterior cerebellum of liver-kidney deficiency group decreased(P<0.05).Conclusion The resting-state cerebral functional magnetic resonance imaging with ALFF analysis can provide imaging evidence for the dialectical classification of traditional Chinese medicine and the treating same disease with different methods of AD patients.