DTI技术在伴与不伴2型糖尿病失眠患者中的应用研究

Application of DTI in insomnia patients with or without type 2 diabetes mellitus.

目的利用磁共振弥散张量成像(DTI)技术观察在伴或不伴2型糖尿病(T2DM)的失眠症患者脑精微解剖结构的变化。方法收集25例合并T2DM的失眠患者纳入伴T2DM失眠组,选择同期临床资料匹配的25例未合并T2DM的失眠患者纳入不伴T2DM失眠组,选择同期健康志愿者25例作为对照组。记录所有受试者的匹兹堡睡眠质量指数(PSQI)、失眠严重指数量表(ISI)和DTI检查。结果不伴T2DM失眠组和伴T2DM失眠组ADC值及PSQI、ISI评分均高于对照组(P<0.05),伴T2DM失眠组ADC值及PSQI、ISI评分均高于不伴T2DM失眠组(P<0.05)。不伴T2DM失眠组和伴T2DM失眠组不同位点FA均低于对照组(P<0.05),伴T2DM失眠组不同位点FA均低于不伴T2DM失眠组(P<0.05)。PSQI、ISI与不同位点FA均呈负相关(P<0.01),PSQI、ISI与不同位点ADC值均呈正相关(P<0.01)。结论DTI技术能够无创地为失眠症患者提供更精准、更早期的影像学评价,为制定失眠症及失眠症向T2DM发展的临床预防诊断提供策略,也为患者采用个体化治疗提供参考。

Objective To explore the changes of brain micro anatomy in insomnia patients with or without type 2 diabetes mellitus(T2DM)through diffusion tensor imaging(DTI).Methods 25 insomnia patients with T2DM(insomnia with T2DM group),25 insomnia patients without T2DM who were matched with clinical data at the same period(insomnia without T2DM group)and 25 healthy controls(control group)were selected.All subjects were assessed with Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI),and DTI tests.Results Compared with control group,insomnia with T2DM group and insomnia without T2DM group showed higher scores of PSQI and ISI as well as higher values of apparent diffusion coefficient(ADC)(P<0.05).Insomnia with T2DM group showed higher scores of PSQI and ISI as well as higher ADC value than insomnia without T2DM group(P<0.05).Compared with control group,insomnia with T2DM group and insomnia without T2DM group showed lower values of fractional anisotropy(FA)at different sites(P<0.05).Insomnia with T2DM group showed lower values of FA at different sites than insomnia without T2DM group(P<0.05).PSQI and ISI were negatively correlated with FA values at different sites(P<0.01),while PSQI and ISI were positively correlated with ADC values at different sites(P<0.01).Conclusion DTI technology can provide more accurate and early imaging evaluation for insomnia patients non-invasively,provide strategies for the clinical prevention and diagnosis of insomnia and its progression to T2DM and also provide reference for personalized treatment for patients.