摘要
目的采用氢质子磁共振波谱成像(1H-MRS)探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)大脑代谢及功能的变化。方法对20例OSAHS患者和20名正常对照组(NC)儿童行1H-MRS扫描和多导睡眠呼吸监测(PSG),记录两组双侧额叶的N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、NAA/胆碱复合物(Cho)、Cho/Cr比值和有无乳酸(Lac)的出现;并记录两组PSG监测指标。采用两独立样本t检验分析两组代谢物及PSG监测指标的变化,OSAHS组双侧额叶脑代谢物与PSG监测指标进行线性相关性分析。结果OSAHS组NAA/Cr、NAA/Cho(2.1925±0.1437、1.5861±0.1713)较对照组(2.7901±0.1437、1.9745±0.1632)明显降低(P值分别为P<0.0001、P=0.0001),Cho/Cr(1.2937±0.1352)较对照组(1.1823±0.1925)明显升高(P=0.0031),差异具有统计学意义(P值均<0.05)。受试者均未见Lac峰。OSAHS组的呼吸暂停低通气指数(AHI)与双侧额叶NAA/Cr、NAA/Cho呈负相关(r值分别为-0.635、-0.617,P值分别为0.003、0.004),而与Cho/Cr无相关性(r=0.029,P=0.904),平均血氧饱和度(MSaO2)与双侧额叶NAA/Cr、NAA/Cho呈正相关(r值分别为0.630、0.640,P值分别为0.001、0.002),而与Cho/Cr无相关性(r=0.008,P=0.974)。结论1H-MRS能较早监测儿童OSAHS脑代谢的变化,为临床治疗和效果评价提供客观的影像学依据。
Objective To analyze the changes of brain metabolism and functionin children with obstructive sleep apnea-hypopnea syndrome(OSAHS)by^1H magnetic resonance spectroscopy(~1H-MRS).Methods Magnetic resonance spectroscopy(~1H-MRS)scanning and PSG were performed on 20 OSAHS patients and 20 NC patients.NAA/Cr,NAA/Cho,Cho/Cr ratio and lactate free(Lac)presence in bilateral frontal lobes of the two groups were recorded.The PSG test indexes of the two groups were recorded.Intergroup differences in the metabolite levels were evaluated using analysis of two-sample t-test,and the linear correlation between brain metabolites and PSG was analyzed by OSAHS group.Results In the frontal lobe,the NAA/Cr、NAA/Cho of the OSAHS(2.1925±0.1437、1.5861±0.1713,respectively)was decreased compared with the healthys subjects(2.7901±0.1437、1.9745±0.1632).The Cho/Cr of the OSAHS(1.2937±0.1352)was increased compared with the healthy(1.1823±0.1925),the difference was statistically significant(P<0.0001、P=0.0001 and P=0.0031,respectively;P values were both less than 0.005).Lac peak was not detected in all.In OSAHS group,AHI was negatively correlated with NAA/Cr and NAA/Cho in bilateral frontal lobes(r=-0.635、-0.617,respectively;P=O.003、0.004,respectively),but not with Cho/Cr(r=0.029,P=0.904).Ma SO2 was positively correlated with NAA/Cr and NAA/Cho in bilateral frontal lobes(r=0.630、0.640,respectively;P=0.001、0.002,respectively),but not with Cho/Cr(r=0.008,P=0.974).Conclusion^1H-MRS can demonstrate brain metabolism early,provide objective imaging basis for clinical treatment and effective in evaluation of children with OSAHS.
作者
王婷婷
冯奇星
钟晓飞
沈善昌
姜兴岳
WANG Tingting;FENG Qixing;ZHONG Xiaofei(Department of Radiology,Binzhou Medical University Hospital,Binzhou,Shandong Province 256603,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第11期2161-2165,共5页
Journal of Clinical Radiology
