Objective To investigate the changes and significant of N-acetylaspartate/choline ( NAA/Cho ) in trans-verse temporal gyri of type 2 diabetic patients with sensorineural hearing loss .Methods Eighty-seven cases of patients with type 2 diabetes mellitus were selected .After the pure tone audiometry screening , they were divided into bilateral deafness group (25 cases), unilateral deafness group (22 cases) and diabetic group (40 cases), meanwhile, seventeen cases of nor-mal healthy volunteers were selected as the control group .All the above groups underwent bilateral transverse temporal gyri hydrogen magnetic resonance spectroscopy (1H-MRS) detection.Then the area under the peak NAA/Cho based on neural me-tabolites was calculated , and the difference between each group was compared;Pearson statistics was used for the analysis of correlation between blood glucose and neural metabolism;ROC curve area >50%was taken as the determination of index in diagnosis of early diabetes mellitus sensorineural hearing loss of sensitivity and specificity .Results Fasting blood glucose levels in diabetic patients were negatively correlated with NAA /Cho (r=-0.547, P<0.05).Compared with the control group, the NAA/Cho in the auditory cortex of affected and contralateral sides of bilateral deafness group , unilateral deafness group and diabetic group all decreased (all P<0.05);in the unilateral deafness group , NAA/Cho in the affected side de-creased as compared with the healthy side (P<0.05);when the NAA/Cho was 1.65, the sensitivity and specificity in diag-nosis of sensorineural deafness were 100%and 88%, respectively;and the ROC curve was 76%.Conclusion NAA/Cho was decreased in the transverse temporal gyri of pure diabetic patients , and the decrease was more significant in the diabetic patients accompanied by nerve deafness .NAA/Cho may be used as the early warning indicators of sensorineural deafness .%目的：探讨2型糖尿病感音神经性聋患者颞横回N-乙酰天门冬氨酸／胆碱（ NAA／Cho ）的变化及意义。方法2型糖尿病患者87例，经纯音听阈筛查，分为糖尿病双侧耳聋组（25例）、糖尿病单侧耳聋组（22例）、单纯糖尿病组（40例），健康志愿者17例为正常对照组，上述各组均行双侧颞横回听神经皮层磁共振氢质子波谱检测，根据神经代谢产物峰下面积计算NAA／Cho，并比较上述各组差异；Pearson统计用于分析血糖值与NAA／Cho的相关性；ROC曲线下面积＞50％作为判定该指标诊断早期糖尿病并发感音神经性聋的灵敏度及特异度。结果糖尿病患者空腹血糖值与NAA／Cho呈负相关（P＜0．05）；与正常对照组相比，单纯糖尿病组、糖尿病双侧耳聋组、糖尿病单侧耳聋组的患侧与健侧听神经皮层NAA／Cho均下降（r＝－0．547，P均＜0．05），糖尿病单侧耳聋组患侧与健侧相比，NAA／Cho降低（P＜0．05）；NAA／Cho在1．65时，诊断感音神经性聋的敏感性为100％，特异性为88％， ROC曲线下面积为76％。结论单纯糖尿病患者颞横回已出现NAA／Cho降低，伴有感音神经性的患者降低更明显。 NAA／Cho有可能作为判定2型糖尿病患者发生感音神经性聋发生的预警指标。
展开▼
