应用基于体素的形态学测量在不同程度OSAHS脑灰质密度变化的研究

目的应用基于体素的形态学测量(VBM)技术初步探讨不同程度的OSAHS对大脑微观结构的影响。 方法应用PHILIPS 3.0 T磁共振对通过脑MRI-VBM技术比较研究2016年1月至2017年12月我院确诊的轻、中、重度OSAHS患者的脑结构变化情况。 结果①本研究对55例确诊的OSAHS患者依据睡眠呼吸暂停低通气指数(AHI)将其分为轻、中、重度，各组间年龄、性别及海拔无明显差异(均P>0.05)，轻度组平均血氧饱和度(MSpO₂)、最低氧饱和度(LSpO₂)均明显高于中度、重度组(P<0.05)，重度OSAHS组AHI显著高于轻度、中度组(P＝0.000); ②中度OSAHS患者与轻度OSAHS患者VBM-MRI相比较，包括左侧杏仁核、左侧海马、左侧脑岛脑灰质体积减少；③重度OSAHS患者与轻度OSAHS患者VBM-MRI相比较，右侧海马旁回脑灰质体积减少；④重度OSAHS患者与中度OSAHS患者VBM-MRI相比较：包括左侧脑岛、左侧尾状核、左侧豆状壳核脑灰质体积增加；左侧丘脑、右侧丘脑脑灰质体积减少。 结论不同程度的OSAHS患者间歇缺氧下导致脑灰质有不同程度的变化，说明了OSAHS对患者的脑结构有着一定程度的影响。

Gray matter volume alterations in patients with obstructive sleep apnea hypopnea syndrome by using voxel-based morphometry of magnetic resonance imaging

Objective To investigate the gray matter volumes(GMV)alterations in the patients with obstructive sleep apnea hypopnea syndrome(OSAHS)by using voxel-based morphometry(VBM)of magnetic resonance imaging(MRI).Methods A total of 55 OSAHS patients who were diagnosed by polysomnography(PSG)in the Affiliated Hospital of Qinghai University from January 2016 to December 2017 were enrolled for this study.According to the apnea hypopnea index(AHI),they were divided into a mild group,a moderate group and a severe group.These groups were matched with the altitude,age,gender and residential elevation.Then we used the VBM to compare the whole brain GMV among the mild group,moderate group and severe group.Results①No significant difference was found in the altitude,age,gender and residential elevation among the groups(P>0.05).The mean oxygen saturation in the mild group was higher than those of the moderate group and the severe group(P<0.05)and the AHI in the severe group was higher than those of the mild group and the moderate group(P=0.000).②The volumes of the left amygdala,left hippocampal and left insular gray matter in the patients with moderate OSAHS were decreased compared with those in the mild patients.③The volume of the right parahippocampal gray matter was decreased in the severe OSAHS patients compared with the mild patients.④The volumes of the left caudate nucleus and left-sided putamen gray matter in the patients with severe OSAHS were increased,and bilateral thalamic volume was reduced compared with the moderate group.Conclusion The changes of brain regions of different degrees of OSAHS patients′gray matter volumes were different,which indicates that different degrees of OSAHS may affect different brain structures.