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氢质子磁共振波谱在帕金森病诊断中的应用研究
目的 探讨氢质子磁共振波谱(1H-MRS)对于帕金森病(PD)诊断的临床应用价值.方法 选择2013年5月-2014年12月内蒙古医科大学附属医院神经内科帕金森病患者31例(PD组)和健康体检者34例(健康对照组)行常规MR和1H-MRS成像检查,测量黑质和红核的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)和胆碱(Cho)含量,计算NAA/Cr、NAA/Cho和Cho/Cr比值,将所得数据进行组间比较.结果 PD组黑质和红核NAA峰明显低于健康对照组(P&0.05).PD组左侧黑质和红核NAA/Cr值和NAA/Cho值均低于右侧,且差异有统计学意义(P&0.05);不同H-Y分级患者比较,晚期亚组、中期亚组、左侧黑质NAA/Cho低于早期亚组(P&0.05);不同HAMD评分患者比较,轻度亚组、中度亚组右侧黑质NAA/Cr值和Cho/Cr值低于正常亚组,差异有统计学意义(P&0.05);不同MoCA评分患者比较,重度亚组、中度亚组右侧黑质NAA/Cho值低于正常亚组,差异有统计学意义(P&0.05),重度组右侧黑质NAA/Cho值最低.结论 1H-MRS目前虽不能作为PD诊断的依据,但在PD抑郁和认知功能障碍的研究中显示了积极作用.
Abstract：
Objective To investigate the clinical value of 1H MRS in the diagnosis of Parkinson's disease.Methods Thirty-one patients with Parkinson's disease and 34 healthy control performed conventional MRI and 1H MRS imaging.Then measured the levels of N acetyl compounds (NAA),creatine (Cr) and choline compounds (Cho) in nigra and red nucleus in all patients and healthy subjects by 1H MRS examination.And compared NAA / Cr,NAA / Cho and Cho / Cr ratios between the patient group and healthy control group and analyzed the relationship of the ratios the MoCA,HAMD,ADL and UPDRSIII scores of all PD patients.Results In the study of 1H MRS,NAA / Cr values and NAA / Cho values between the both sides of nigra,the NAA / Cr values and NAA / Cho values between both sides of red nucleus in the patient group were significantly different (P&0.05).According to the ADL scores,HAMD scores and MOCA scores,the patients with PD were divided into three or four groups.The NAA / Cr value and Cho / Cr values in the right substantia nigra between patients with mild depression,moderate depression and without depression were significantly different (P&0.05).The NAA / Cho values in the right substantia nigra were significantly different among different groups according with MoCA scores (P?&0.05).Moreover,there was correlation of H Y grade in PD patients with the NAA / Cho values in the right red nucleus,their HAMD scores with NAA/Cr values in the right nigra,the NAA / Cr values in the left substantia nigra,and Cho / Cr values in the right nigra,and MOCA scores with the NAA / Cho values in right substantia nigra.Conclusion 1H MRS cannot be the diagnostic criteria of PD,but show a positive role in the study of depression and cognitive about Parkinson's disease.
JIANG Mingfang
NIU Guangming
XIE Shenghui
作者单位：
内蒙古医科大学附属医院神经内科, 呼和浩特,010059
内蒙古医科大学附属医院影像科, 呼和浩特,010059
内蒙古自治区中医医院放射科, 呼和浩特,010020
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