合并认知障碍的多系统萎缩患者磁共振氢质子波谱

目的：应用磁共振氢质子波谱(1H-proton magnetic resonance spectroscopy，1H-MRS)检测合并认知功能障碍 的多系统萎缩(multiple system atrophy，MSA)患者双侧额叶的代谢特点。方法：收集23例合并认知功能障碍的MSA 患者(研究组1)及19例认知功能正常的MSA患者(研究组2)，另选48名与两组MSA患者年龄、性别匹配的正常人(正 常对照组)均进行1H-MRS检查，其包括双侧额叶区N-乙酰天门冬氨酸(N-acetylaspartate，NAA)/肌酸(creatine，Cr)、 胆碱(choline，Cho)/肌酸(Cr)、肌醇(myoinositol，mI)/肌酸(Cr)的测定。结果：合并认知障碍的MSA患者双侧额叶 NAA/Cr值较认知正常的MSA患者和正常对照组显著降低(P<0.05)；MSA患者右侧额叶mI/Cr值较正常对照组显著增高 (P<0.05)；双侧额叶Cho/Cr值3组间差异无统计学意义(P>0.05)。合并认知功能障碍的MSA患者双侧额叶NAA/Cr值与 病程呈负相关，与MoCA评分成正相关。结论：首次在国内应用1H-MRS技术发现额叶NAA/Cr值下降、mI/Cr值增高 可能与MSA患者认知功能障碍有关。

1H-proton magnetic resonance spectroscopy in patients with multiple system atrophy and cognitive dysfunction

Objective: To detect metabolic changes of bilateral frontal lobe in patients with multiple system atrophy (MSA) and cognitive dysfunction by 1H-proton magnetic resonance spectroscopy (1H-MRS). Methods: N-acetylaspartate (NAA)/creatine(Cr), choline (Cho)/Cr, myoinositol (mI)/Cr in three sides of frontal lobe were detected by 1H-MRS in 48 healthy controls, 23 patients with MSA and cognitive dysfunction and 19 patients with MSA but without cognitive dysfunction. Results: NAA/Cr of bilateral frontal lobes in patients with MSA and cognitive dysfunction was significantly decreased compared with MSA patients without cognitive dysfunction and healthy controls (P<0.05). mI/Cr of right frontal lobes was significantly increased in patients with MSA and cognitive dysfunction compared with healthy controls (P<0.05). There was a negative correlation between NAA/Cr of bilateral frontal lobes and duration while a positive correlation between NAA/ Cr of bilateral frontal lobes and MoCA score in patients with MSA and cognitive dysfunction. Conclusion: There is a decrease in NAA/Cr and an increase in mI/Cr in frontal lobes in patients with MSA and cognitive dysfunction, which may be associated with cognitive dysfunction in MSA patients.