阻塞型睡眠呼吸暂停低通气综合征继发红细胞增多症脑静息态fMRI研究

A Resting-fMRI Brain Study of Obstructive Sleep Apnea Hypopnea Syndrome with Polycythemia

目的应用基于体素的形态学测量(VBM)、局部一致性(ReH o)及低频振幅(ALFF)的方法探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)继发红细胞增多症后脑结构及功能的进一步改变。方法搜集经多导睡眠仪确诊的OSAHS患者46例,在多次血常规及生化检查中筛查出合并红细胞增多症的患者21例,余25例为单纯OSAHS患者。全部受检者行全脑磁共振结构及功能扫描,运用VBM、ReH o、ALFF分析处理获得的脑结构及功能数据。结果与单纯OSAHS组相比,OSAHS继发红细胞增多症组未见灰质体积增加或萎缩的脑区。与单纯OSAHS组相比,OSAHS继发红细胞增多症组脑功能变化主要出现在左侧半球。OSAHS继发红细胞增多症组在左侧背侧额上回、额中回、三角部额下回、中央前回ReH o值增加(P <0. 05,Alphasim校正);在左侧三角部额下回、岛盖部额下回、额中回、中央前回及岛叶ALFF值增加(P <0. 05,Alphasim校正);全脑未见ReH o及ALFF值减低的脑区。结论 OSAHS继发红细胞增多症较单纯OSAHS的脑功能方面存在进一步损害。

Objective To investigate the changes in brain structure and function by voxel-based morphology(VBM),regional homogeneity(ReH o)and amplitude of low frequency fluctuation(ALFF)for obstructive sleep apnea hypopnea syndrome(OSAHS)after polycythemia.Methods 46 cases with OSAHS diagnosed by polysomnography were recruited in the study.21 cases of OSAHS with polycythemia were found by multiple blood tests and biochemical examinations as the case group,and the remamed 25 cases of OSAHS were the control group.Structure and functional sequences were performed on all patients’brain,using ReH o,ALFF and VBM methods to compare the two groups.Results Compared with the control group,there was no brain area with increased or decrease gray matter volume.Compared with the control group,altered brain function was mainly in the left hemisphere;the brain areas with higher ReH o values were the left frontal dorsum gyrus,the left middle frontal gyrus,the left Inferior frontal triangle gyrus,the left precentralgyrus(P<0.05,Alphasim corrected);the brain areas with higher ALFF values were the left front triangle and island cover gyrus,the left middle frontal gyrus,the left precentralgyrus,the left insula(P<0.05,Alphasim corrected);No significant brain regions with reduced ReH o and ALFF values were found.Conclusion There are differences in brain function between OSAHS with polycythemia and OSAHS.