摘要
目的:探讨1H-MRS在ALS患者的临床应用价值.方法:对34例ALS病人双侧大脑中央前回进行质子波谱分析,同时进行临床量表评分,并随访其中进行治疗的24例病例.治疗组分两组:力如太组(力如太50mg bid)和免疫治疗组(环磷酰胺和地塞米松).结果:①NAA/Cr比值在ALS病人上显著降低,P<0.0l;②力如太治疗最初的1个月,NAA/Cr比值上升,P<0.05,而免疫治疗组(环磷酰胺+地塞米松)无此变化;③NAA/Cr的改善与力如太组在Appel延髓评分的改善相一致,且NAA/Cr比值更为敏感.结论:1H-MRS中的NAA/Cr比值可以作为大脑中央前回运动神经元受损的指标,并且也可用来客观地监测疾病的进展,观察药效.
Aim:To have a preliminary evaluation of1H-MRS application in ALS patients.Methods: Our study focused upon the precentral gyrus to determine whether any signal changes could be detected in ALS patients ( n = 34), and to determine whether any intervention could reverse corticomotoneuron damage in patients with ALS ( n = 24) . All the patients had the clinical ALS scales evaluation as well. We divided the population into two groups: treated patients in the first group with rilutek (rilutek 50 mg bid), patients in the second group receiving immune therapy (cyclophosphamidum combined with dexamethasone). Results: (1) ALS patients have significantly reduced NAA resonance intensity relative to Cr (P<0.01). (2) After one month of therapy, this parameter (NAA/Cr) significantly increased (P<0.05) in the rilutek-treated patients, but remained unchanged in the immune therapy group. (3) The improvement of NAA/Cr was consistent with improvement of bulbar score (Appel Scale) in the rilutek group. The foregoing NAA/Cr appeared to be more sensitive than ALS scale with respect to detection of drug effects. Conclusion: NAA/ Cr could be used as a surrogate corticomotoneuron marker. Furthermore, it could also be used to monitor disease progression or to assess responses to drug therapy.
出处
《中国临床神经科学》
2003年第1期49-52,共4页
Chinese Journal of Clinical Neurosciences
基金
基金资助来自安万特公司(ALS研究基金项目)
关键词
肌萎缩侧索硬化
质子磁共振波谱
NAA/Cr
诊断
治疗
amyotrophic lateral selerosis(ALS) magnetic resonance spectroscopy(1H-MRS) N-acetylaspartate/creatine(NAA/Cr)