磁共振参数及TNF-α、IL-1α水平在阿尔兹海默病中的诊断价值研究

The diagnostic value and correlation of magnetic resonance parameters with TNF-αand IL-1αlevels in Alzheimer’s disease

目的探讨扩散峰度成像参数平均扩散系数(mean diffusivity,MD)、各向异性分数(fractional anisotropy,FA)、平均弥散峰度(mean kurtosis,MK)、轴向峰度(axial kurtosis,AK)、径向峰度(radial kurtosis,RK)以及血清肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、白细胞介素1α(interleukin-1α,IL-1α)水平对阿尔兹海默病(Alzheimer’s disease,AD)的诊断价值。方法选取2020年7月至2022年7月就诊于绍兴市第七人民医院的60例阿尔兹海默病患者为研究对象,提供多模态磁共振成像(magnetic resonance imaging,MRI)常规序列检查,测量患者脑部颞叶、顶叶、海马、丘脑、尾状核头、红核、齿状核、黑质部位的MD、FA、MK、AK、RK;抽取患者外周静脉血,ELISA法检测血清中TNF-α、IL-1α水平。结果阿尔兹海默病患者各脑区MD值显著升高;颞叶及顶叶皮质下白质、海马、黑质的FA值减小,尾状核头、红核、齿状核的FA值升高;颞叶及顶叶皮质下白质、海马、丘脑的RK值显著降低,黑质部位的RK值显著升高;颞叶及顶叶皮质下白质、丘脑、齿状核部位的AK值显著降低;颞叶及顶叶皮质下白质、海马、丘脑部位的MK值显著降低,尾状核头、黑质部位的MK值显著升高;TNF-α水平显著升高,IL-1α水平显著降低,差异均有统计学意义(P<0.05)。结论联合磁共振扩散峰度成像参数和检测血清TNF-α、IL-1α水平的方法对阿尔兹海默病发生具有一定的诊断预测价值。

Objective To explore the diagnostic value of magnetic resonance DKI parameters and serum levels of tumor necrosis factor-alpha(TNF-α)and interleukin-1α(IL-1α)in Alzheimer's disease(AD).Methods From July 2020 to July 2022,60 patients with Alzheimer's disease in our hospital were selected as the observation group and 60 healthy elderly people over 60 years old as the control group.All patients underwent routine MRI sequence examination,measured DKI parameters,and detected serum TNF-αand IL-1αlevels by ELISA.Results The MD value of each brain area was significantly increased in alzheimer's disease patients.FA of white matter,hippocampus and substantia nigra decreased in temporal and parietal cortex,while FA of caudate nucleus,red nucleus and dentate nucleus increased.RK of white matter,hippocampus and thalamus in temporal and parietal cortex decreased significantly,while RK in substantia nigra increased significantly.AK of white matter,thalamus,dentate nucleus and substantia nigra in temporal and parietal cortex were significantly decreased.The MK in white matter,hippocampus and thalamus of temporal and parietal cortex decreased significantly,while the MK in caudate nucleus and substantia nigra increased significantly.The serum levels of homotype hemisoline and acetylcholinesterase increased significantly.Conclusion Combined magnetic resonance DKI parameters and detection of serum TNF-αand IL-1αlevels have certain diagnostic and predictive value for the occurrence of Alzheimer's disease.