摘要
目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的质子磁共振波谱（1H-MRS）改变及其临床应用价值。方法：对26例OSAHS患者和12例健康志愿者（正常对照组）行1H-MRS检查。根据临床表现和多导睡眠呼吸监测结果将患者分为轻度组10例和中重度组16例。分别测量脑皮质和白质代谢物氮-乙酰天门冬氨酸（NAA）、胆碱复合物（Cho）、肌酸及磷酸肌酸（Cr）波峰下面积，比较各组间NAA/Cho、NAA/Cr、Cho/Cr的差异，并观察有无乳酸（Lac）峰出现。结果：中重度组患者的脑白质NAA/Cho低于轻度组和正常对照组，差异有统计学意义（P＜0.01），NAA/Cr轻度降低，Cho/Cr轻度升高，但差异无统计学意义（P＞0.05）。轻度组与正常对照组的脑白质以及各组间脑皮质NAA/Cho、NAA/Cr、Cho/Cr的比较差异均无统计学意义（P＞0.05）。各组均未发现Lac峰。脑白质的NAA/Cho与睡眠呼吸暂停低通气指数（AHI）呈负相关（r=-0.36，P＜0.01）。结论：1H-MRS能敏感显示OSAHS患者存在的脑代谢异常，为临床早期诊治提供客观的影像学依据。
Abstract
Objective: To investigate the cerebral metabolic changes in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) by 1H magnetic resonance spectroscopy(1H-MRS), and to explore the value of 1H-MRS on OSAHS. Methods: 1H-MRS was performed in 26 patients with OSAHS and 12 control subjects. The patients were classified into two groups based on clinical manifestations and the results of polysomnography(PSG): mild OSAHS(10 patients) or moderate to severe OSAHS(16 patients). Cerebral metabolism was studied by assessing ratios of N-acetylaspartate(NAA) to choline(Cho) and to creatine(Cr) as well as Cho to Cr was calculated from the peak areas in normal-appearing regions of cerebral white matter or cortex selected. Results: In the patients with moderate to severe OSAHS, the NAA/Cho ratios for the white matter were significantly decreased and lower than that of the control subjects as well as mild OSAHS(P＜0.01). The ratios of NAA/Cr and Cho/Cr had no obvious changes(P＞0.05). However, no significant difference in the three metabolite ratios was found between patients with mild OSAHS and control subjects for cerebral white matter, as well as among three groups for cerebral cortex(P＞0.05). None of the subjects exhibited an obvious lactate signal in brain tissue. There was a negative correlation between the NAA/Cho ratios for the white matter and apnea hypopnea index(AHI)(r=-0.36, P＜0.01). Conclusion: 1H-MRS was sensitive to demonstrate the metabolic impairment in patients with moderate to severe OSAHS, and can provide valuable diagnostic and therapeutic information.
关键词
睡眠呼吸暂停综合征 /
磁共振波谱学
Key words
Sleep apnea syndromes /
Magnetic resonance spectroscopy
王金月;刘 筠;杨 筠;秦永欣;王荣仁;郝彩仙;刘学焕.
阻塞性睡眠呼吸暂停低通气综合征的1H-MRS初步研究[J]. 中国临床医学影像杂志. 2008, 19(11): 761-764
WANG Jin-yue;LIU Jun;YANG Jun;QIN Yong-xin;WANG Rong-ren;HAO Cai-xian;LIU Xue-huan.
Initial study of 1H-MR spectroscopy in obstructive sleep apnea hypopnea syndrome[J]. Journal of China Clinic Medical Imaging. 2008, 19(11): 761-764
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