皮质下缺血性脑血管病的磁共振波谱研究

摘要

Objective:To investigate cerebral metabolite levels of patients with subcortical ischemic vascular disease (SIVD)and study the relationship between cerebral metabolic levels and cognitive impairment.Method:We used multiple voxel proton magnetic resonance spectroscopy (1 H-MRS)to measure the peak value of MRS of N-acetyl as-partate (NAA),choline (Cho)and creatine (Cr)in the frontal cortex,parietal cortex and white matter of 32 SIVD patients and 2 1 controls.Results:(1 )For patients with SIVD,NAA/Cr in frontal cortex,white matter of frontal lobe,parietal cortex and white matter of parietal lobe were reduced when compared with those in control group(P<0.01).(2)Compared to controls,patients with SIVD had higher Cho/Cr in parietal cortex and white matter of parie-tal lobe (P<0.01),but there was no significant difference of Cho/Cr in frontal cortex and white matter of frontal lobe.(3 )Compared to SIVD patients without cognitive impairment,patients with cognitive impairment had de-creased NAA/Cr in frontal cortex,parietal cortex and parietal white matter;However,no significant Cho/Cr change was found.Conclusion:These results showed that the presence of altered cerebral metabolite levels among patients with SIVD,and the change of the metabolite levels in frontal and parietal lobes was associated with cognitive impairment.%目的：检测皮质下缺血性脑血管病(SIVD)患者和正常对照组不同脑区脑组织的代谢水平,探讨其与认知功能损害的关系。方法：采用多体素磁共振波谱(1 H-MRS)技术评测 SIVD患者(SIVD组,n=32例)和体检健康人(对照组,n=21)额叶及顶叶皮质、白质的代谢物 N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)；计算有关比值NAA/Cr、Cho/Cr,分析有无认知功能损害 SIVD患者上述比值的变化。结果：(1)SIVD 组额叶皮质、白质及顶叶皮质、白质各体素 NAA/Cr比值明显低于对照组(P<0.01)；(2)SIVD组顶叶皮质及白质的 Cho/Cr比值明显高于对照组(P<0.01)；(3)SIVD组有认知功能损害患者的额叶皮质和顶叶皮质、白质 NAA/Cr 比值显著低于无认知功能损害者(P值分别<0.01、<0.01、<0.05),Cho/Cr比值的两者间差异无统计学意义(P>0.05)。结论：SIVD患者脑组织存在 NAA/Cr、Cho/Cr比值改变,且额叶皮质和顶叶皮质、白质 NAA/Cr的下降与认知损害有关。