CAJ | 학술논문

目的：研究阿尔兹海默病(Alzheimer’s disease,AD)患者海马内不同区域(头、体、尾)的代谢物改变及分布规律,为 AD的早期诊断奠定基础。方法对30例 AD患者和30例认知正常老年人(normal cognitive elders,NC)行3.0 T MR海马区多体素氢质子波谱检查。采用Philips Achieva 3.0T MR后处理工作站对波谱数据进行处理。将海马分为3部分(头、体、尾),分别计算其N-乙酰天冬氨酸(n-acetylaspartate,NAA)/肌酸(creatine,Cr)、肌醇(myoinositol,MI)/Cr 和 MI/NAA 的比值。比较 AD 和 NC组间各代谢物比例及分布规律的改变。结果 AD组较 NC 组两侧海马体尾部的 NAA/Cr 均下降,MI/Cr、MI/NAA 均升高(P<0.01),左侧海马头部 MI/NAA亦升高(P<0.01)。NC组中两侧海马由头至尾 NAA/Cr逐步上升(P<0.01),MI/NAA逐步下降(P<0.01)。AD组各代谢物比例在两侧海马无分布差异。结论 AD 患者海马神经元弥漫退行性变,胶质细胞弥漫增生。依据海马各区域代谢物改变及分布规律的消失对临床早期诊断 AD具有很大帮助。
목적：연구아이자해묵병(Alzheimer’s disease,AD)환자해마내불동구역(두、체、미)적대사물개변급분포규률,위 AD적조기진단전정기출。방법대30례 AD환자화30례인지정상노년인(normal cognitive elders,NC)행3.0 T MR해마구다체소경질자파보검사。채용Philips Achieva 3.0T MR후처리공작참대파보수거진행처리。장해마분위3부분(두、체、미),분별계산기N-을선천동안산(n-acetylaspartate,NAA)/기산(creatine,Cr)、기순(myoinositol,MI)/Cr 화 MI/NAA 적비치。비교 AD 화 NC조간각대사물비례급분포규률적개변。결과 AD조교 NC 조량측해마체미부적 NAA/Cr 균하강,MI/Cr、MI/NAA 균승고(P<0.01),좌측해마두부 MI/NAA역승고(P<0.01)。NC조중량측해마유두지미 NAA/Cr축보상승(P<0.01),MI/NAA축보하강(P<0.01)。AD조각대사물비례재량측해마무분포차이。결론 AD 환자해마신경원미만퇴행성변,효질세포미만증생。의거해마각구역대사물개변급분포규률적소실대림상조기진단 AD구유흔대방조。
Objective To investigate the metabolic changes and the metabolites distribution of different hippocampal regions (head,body and tail)in patients with Alzheimer’s disease (AD)using 1 H-MRS for early diagnosis.Methods The hippocampal multivoxel 1H-MRS at 3.0 T was scanned in 30 patients with AD and other 30 normal cognitive elders (NC)as contrast.The data obtained were processed at a workstation.The hippocampus was divided into 3 parts (head,body and tail),and the ratios of N-acetylaspartate (NAA)/creatine (Cr),myoinositol (MI)/Cr and MI/NAA were calculated respectively.The metabolite ratios and distribution changes were compared between group AD and NC.Results Compared with the group NC,the NAA/Cr in group AD in bilateral hippocampal body and tail was decreased,whereas the MI/Cr and MI/NAA in bilateral body and tail,MI/NAA in left head were opposite (P<0.01).In group NC,the NAA/Cr was gradually decreased from the bilateral hippocampal heads to tails (P<0.01),however,the MI/NAA was opposite (P<0.01).No distribution differences in every metabolic ratios of bilateral hippocam-pus were found in AD group (P>0.05).Conclusion Metabolic changes and disappearance of the normal distribution in different hippocampal regions detected by 1 H-MRS provide helpful clues for early diagnosis of the AD.