| 胡霞
，周苏键
，苏静
，彭慧平.创伤性脑损伤后认知障碍的海马氢质子磁共振波谱分析[J].神经损伤功能重建,2021,16(5):253-257 |
| 创伤性脑损伤后认知障碍的海马氢质子磁共振波谱分析 |
| Hippocampal Hydrogen Proton Magnetic Resonance Spectroscopy Analysis of CognitiveImpairment After Traumatic Brain Injury |
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| DOI： |
| 中文关键词: 创伤性脑损伤 认知障碍 磁共振波谱 |
| 英文关键词: traumatic brain injury cognitive impairment magnetic resonance spectroscopy |
| 基金项目: |
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| 摘要点击次数: 3556 |
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| 中文摘要: |
| 目的：探讨海马氢质子磁共振波谱（1
H-MRS）在创伤性脑损伤（TBI）后认知障碍的辅助诊断和评估中
的价值。方法：选取轻度TBI后认知障碍患者（mi-TBI组）9例、中度TBI后认知障碍患者（mo-TBI组）19
例，同时招募健康对照组10例，进行1
H-MRS 检查后分析三组双侧海马N-乙酰天门冬氨酸（NAA）、胆碱
（Cho）、肌酸（Cr）代谢物浓度。采用简易精神状态量表（MMSE）和蒙特利尔认知功能评估量表（MoCA）进
行认知评估，比较三组间认知功能评分和代谢物比值的差别，并进行相关性分析。结果：mi-TBI组、mo-TBI
组的双侧海马NAA/Cr值、NAA/(Cho+Cr)值均低于健康对照组（P＜0.05），右侧海马Cho/Cr值均高于健康
对照组（P＜0.05），左侧海马Cho/Cr值差异无统计学意义（P＞0.05）。mi-TBI组、mo-TBI组的MMSE、MoCA 评分均低于健康对照组（P＜0.05）。mi-TBI 组的 MMSE、MoCA 评分与双侧海马 NAA/Cr 均呈正相关
（P＜0.05），与左侧海马Cho/Cr无显著相关性（P＞0.05），与右侧海马Cho/Cr呈负相关（P＜0.05），与双侧海
马NAA/(Cho+Cr)均呈正相关（P＜0.05）。mo-TBI组MMSE、MoCA评分均与左侧海马NAA/Cr呈正相关
（P＜0.05），与右侧海马NAA/Cr呈负相关（P＜0.05），与双侧海马Cho/Cr无显著相关性（P＞0.05），但与健康
对照组相比，Cho/Cr比值有升高的趋势，与双侧海马NAA/(Cho+Cr)均呈正相关（P＜0.05）。结论：1
H-MRS
结合神经认知测试有助于更客观、更准确地辅助诊断TBI后认知功能障碍。 |
| 英文摘要: |
| To explore value of hippocampal hydrogen proton magnetic resonance spectroscopy
(1
H-MRS) in diagnosis and evaluation of cognitive impairment after traumatic brain injury (TBI). Methods:
Nine patients with mild post-TBI cognitive impairment (mi-TBI group) and 19 patients with moderate post-TBI
cognitive impairment (mo-TBI group) were enrolled. At the same time, 10 healthy subjects (control group) were
recruited. The concentration of each metabolite in the bilateral hippocampus of the three groups were analyzed
after 1H-MRS examination: N-acetylaspartic acid (NAA), choline (Cho), and creatine (Cr). Neurocognitive tests
included the Mini Mental State Scale (MMSE) and Montreal Cognitive Function Assessment Scale (MoCA),
and the differences in cognitive function scores and metabolite ratio among the three groups were compared.
Correlation analysis on the above data results was performed. Results: The NAA/Cr and NAA/(Cho+Cr) ratio
of the bilateral hippocampus of the patient groups were lower than those of the control group (P<0.05). The Cho/
Cr ratio of the right hippocampus of the patient groups was higher than that of the control group (P<0.05). The
Cho/Cr ratio of the left hippocampus showed no significant difference between the groups (P>0.05). The MMSE
and MoCA scores of the two patient groups were lower than those of the control group (P<0.05). The MMSE
and MoCA scores in the mi-TBI group were positively correlated with the NAA/Cr ratio of the bilateral
hippocampus (P<0.05) and had no significant correlation with the Cho/Cr ratio of the left hippocampus (P> 0.05), but the scores showed a negative correlation with the Cho/Cr ratio of the right hippocampus (P<0.05) and
a positive correlation with the NAA/(Cho + Cr) ratio of the bilateral hippocampus (P<0.05). The MMSE and
MoCA scores in the mo-TBI group were positively correlated with the NAA/Cr ratio of the left hippocampus (P< 0.05), negatively correlated with the NAA/Cr ratio of the right hippocampus (P<0.05), and had no significant
correlation with the Cho/Cr ratio of the bilateral hippocampus (P>0.05); however, compared with that of the
control group, the Cho/Cr ratio tended to increase and was positively correlated with bilateral hippocampal
NAA/(Cho+Cr) ratio (P<0.05). Conclusion: 1
H-MRS combined with neurocognitive tests can help to diagnose
cognitive dysfunction more objectively and accurately after TBI. |
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