摘要
目的采用运动皮质及相关脑区的质子磁共振波谱检查，分析上运动神经元明显受累的肌萎缩侧索硬化症患者嗅鞘细胞移植后质子谱变化。方法2004年12月～2005年2月，收治7例肌萎缩侧索硬化症（amyotrophic lateral sclerosis，ALS）患者，男3例，女4例。年龄25～67岁。按E1 Eseorial诊断标准确诊。嗅鞘细胞移植术前及术后2周检查其神经功能状态、肌萎缩侧索硬化症功能评分、肌电图和质子磁共振波谱。分别于大脑脚、内囊膝部、内囊后肢、放射冠和中央前回测量N-乙酰天冬氨酸／肌酐和胆碱复合物／肌酐比值。结果7例患者均进入结果分析。嗅鞘细胞移植后2周2例患者功能评分明显改善（ALs功能评分ALSFRs分别由30增至33分，29分增至34分），其余5例保持稳定。7例患者N-乙酰天冬氨酸／肌酐和胆碱复合物／肌酐整体水平降低（1．624降至1．531），但2例改善的患者在其相应的解剖区域N-乙酰天冬氨酸／肌酐升高（NAA／Cr分别由1．236增至1．316，1．438增至1．560）。结论初步研究表明嗅鞘细胞移植术后2周内7例ALS患者中的2例明显改善。质子磁共振波谱是一项适用于肌萎缩侧索硬化评估的无创检查方法，但需更多病例数和长期随访进一步研究。
Objective To evaluate proton MR spectroscopy （IH-MRS） for detection of the motor cortex and adjacent brain in amyotrophic lateral sclerosis （ALS） patients with apparent upper motor neuron involvement after olfactory ensheathing cells（OECs） transplantation. Methods From December 2004 to February 2005, 7 patients with clinically definite ALS who could safely undergo MRS were admitted into the perspective study. The neurological status, ALS functional rating scale （ALSFRS）, EMG, and ^1H-MRS taken before and 2 weeks after operations were carefully analyzed. The NAA/Cr and Cho/Cr ratios were measured in the cerebral peduncle, genu and posterior llmb of the internal capsule, corona radiata and precentral gyms. Results The ALSFRS in 2 cases improved obvi- ously whose ALSFRS increased from 30 to 33 and from 29 to 34 respectively. And 5 cases remained stable 2 weeks after OECs transplan- tation. Statistical analyses for all seven cases showed both the NAA/Cr and Cho/Cr ratios decreased, but in the two cases with ALSFRS improvement the NAA/Cr increased in the certain anatomic position which confirmed the neurological and EMG findings. The proton MR spectroscopy is a suitable noninvasive measure for ALS evaluation. The preliminary study suggests that two of the seven ALS cases improved apparently short-term after OECs transplantation. More patients are required for the clinical study and longer followup duration is needed for future research.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2007年第1期52-57,共6页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肌萎缩侧索硬化症
嗅鞘细胞
质子磁共振波谱
功能评分
Amyotrophic lateral sclerosis Olfactory ensheathing cells Proton MR spectroscopy ALS functional raung scale
