部分性继发全身强直-阵挛发作癫痫患者双侧丘脑的氢质子磁共振波谱研究

摘要

Objective: To examine the changes of metabolites in the bilateral thalamus of patients with secondarily generalized tonic-clonic seizure (SGTCS) and to explore the mechanism of SGTCS. Methods: Thirty patients with SGTCS (epilepsy group) and 30 matched healthy controls (control group) were examined by 1H-magnetic resonance spectroscopy (1H-MRS). The levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine phosphocreatine (Cr-PCr), and myo-inositol (mI) of the bilateral thalamus were measured in both the epilepsy group and the control group. The ratios of NAA/Cr-PCr, NAA/(Cr-PCr+Cho), Cho/Cr-PCr and mI/Cr-PCr were compared and analyzed in the 2 groups.Results: The ratios of NAA/Cr-PCr, and NAA/(Cr-PCr+Cho)(1.7074 ± 0.2214; 0.9333 ± 0.2173) in the left thalamus in the epilepsy group were significantly lower than those in the control group( 1.883410.2093; 1.1243±0.2447)(P<0.05). The ratios of NAA/Cr-PCr, and NAA/(Cr-PCr+Cho) (1.7472±0.2439; 0.9165±0.2462) in the right thalamus in the epilepsy group were also significantly lower than those in the control group(1.8925 ± 0.2004; 1.0941 ± 0.2372)(P<0.05). There were no significant differences in the ratios of NAA/Cr-PCr, NAA/(Cr-PCr+Cho), Cho/Cr-PCr, and mI/Cr-PCr between the bilateral thalamis in the epilepsy group (P>0.05). Conclusion: There is neuronal dysfunction in the bilateral thalamus in the epilepsy group. Abnormal changes of the bilateral thalamus are involved in the mechanism of SGTCS.%目的:研究部分性继发全身强直.阵挛发作(secondarily generalized tonic-clonic seizure,SGTCS)癫痫患者双侧丘脑的代谢物变化,探讨部分性SGTCS的发生机制.方法:对30例SGTCS癫痫患者(癫痫组)和30例健康对照者(对照组)进行双侧丘脑氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)检查,测定丘脑N-乙酰天门冬氨酸(N-acetyl aspartate,NAA)、胆碱复合物(choline-containing compounds,Cho)、肌酸和磷酸肌酸(creatine and phosphocreatine,Cr-PCr)、肌醇(myo-inositol,mI)的水平,比较两组间及癫痫组双侧丘脑间的代谢物水平.结果:癫痫组左侧丘脑NAA/Cr-PCr和NAA/(Cr-PCr+Cho)的比值分别为1.7074±0.2214和0.9333±0.2173,明显低于对照组的比值1.8834±0.2093和1.1243±0.2447(P＜0.05)；癫痫组右侧丘脑NAA/Cr-PCr和NAA/(Cr-PCr+Cho)的比值分别为1.7472±0.2439和0.9165±0.2462,明显低于对照组的比值1.8925±0.2004和1.0941 ±0.2372(P＜0.05).癫痫组患者双侧丘脑之间的NAA/Cr-PCr,NAA/(Cr-PCr +Cho),Cho/Cr-PCr,mI/Cr-PCr比值差异无统计学意义(P＞0.05).结论:SGTCS癫痫患者双侧丘脑的神经元功能异常,双侧丘脑参与了SGTCS的发生机制.