颞横回NAA/Cho在阻塞性睡眠呼吸暂停低通气综合征患者听力损伤诊断中的意义

Significance of transverse temporal gyrus NAA / Cho in obstructive patients with hearing loss

目的通过磁共振氢质子波谱(1H-MRS)检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)颞横回听皮层区的神经代谢产物N-乙酰天门冬氨酸/胆碱(NAA/Cho)变化情况,以寻找听力损伤的早期预警指标。方法随机抽取PSG确诊OSAHS患者80例,经纯音听阈筛查将OSAHS患者分为双侧耳聋组(n=26)、单侧耳聋组(n=15)以及单纯OSAHS组(n=39),选择健康志愿者19例作为正常对照组,1H-MRS检测上述各组双侧颞横回听皮层NAA/Cho的变化;利用ROC曲线下面积>50%判定NAA/Cho作为早期提示OSAHS患者合并感音神经性听力损伤的特异度及灵敏度。结果与正常对照组比较,单、双侧耳聋组NAA/Cho降低(P均<0.05);与单纯OSAHS组相比,单侧、双侧耳聋组NAA/Cho降低(P均<0.05);而单侧耳聋组患侧与自身健侧NAA/Cho比较无统计学差异(P>0.05);ROC曲线测定NAA/Cho曲线下面积为78%。结论颞横回听皮层区神经代谢产物NAA/Cho有可能作为提示OSAHS患者感音神经性听力损伤发生的早期预警指标。

Objective To explore the changes of NAA / Cho in transverse temporal gyrus with1H-MRS in obstructive sleep apnea hypopnea syndrome( OSAHS) patients for looking for early warning indicators of hearing damage. Methods80 patients with OSAHS confirmed by PSG were divided into bilateral deafness group( n = 26),unilateral deafness group( n = 15) and simple OSAHS group( n = 39); 19 healthy volunteers were as normal control group.1H-MRS was used to detect NAA / Cho in transverse temporal gyrus of the above groups,then compared with each group; the area under ROC curve of > 50% was used to judge the specificity and sensitivity of NAA / Cho as early tips for OSAHS patients with sensorineural hearing loss. Results Compared with normal control group,OSAHS with( bilateral and unilateral) deafness groups auditory cortex NAA / Cho decreased( all P < 0. 05); compared with the simple OSAHS group,OSAHS groups with( bilateral and unilateral) deafness NAA / Cho also decreased( all P < 0. 05); while there was no significant difference between ipsilateral and contralateral transverse temporal gyrus in unilateral deafness OSAHS group( P > 0. 05). The area of NAA /Cho under the ROC curve was 78%. Conclusion In transverse temporal gyrus,nerve metabolites cortex NAA / Cho may serve as early warning indicator to prompt OSAHS patients with sensorineural hearing damage occur.