代谢综合征患者的MR扩散张量成像研究

目的应用MRI扩散张量成像(DTI)检测病程5年以上代谢综合征(MS)患者的脑部各向异性(FA)值,早期发现亚临床脑神经纤维微结构损害。材料与方法分为病例组(代谢综合征15例)及对照组(17例健康体检者),对一般项目(身高、体重、血压、血糖、血脂、认知等神经功能相关量表评分)检查测定后,进行头颅MRI及DTI检查,对所测得结果进行统计学分析。结果 (1)病例组FA值(内囊后肢、放射冠区)明显低于对照组(P值均<0.01),3项代谢异常者FA值(内囊后肢和放射冠区)降低程度更显著(P值均<0.01),2项代谢异常者只在放射冠区FA值明显低于对照组(P<0.05),差异有统计学意义。(2)高血压组、糖尿病组、高血脂组、肥胖组内囊后肢及放射冠区FA值均明显低于对照组(P值均<0.05),差异有统计学意义。(3)以高血压、糖尿病、高脂血症、肥胖、年龄、病程年限为自变量,FA值为因变量,多元回归分析结果显示:FA值与高脂血症、高血压、肥胖负相关(r值分别为-0.103、-0.127、-0.012,P值均<0.05),放射冠区(CRA)FA值与年龄呈负相关(r=-0.04,P<0.05);与高血压年限呈负相关(r=-0.013,P<0.05)。结论 MS病程5年以上者脑部神经纤维微结构已有损害。脑部神经纤维微结构损害严重程度与代谢异常程度及病程年限明显相关。高血压、高脂血症、肥胖是脑神经纤维微结构损害的独立危险因素。

Diffusion tensor imaging study of patients with metabolic syndrome

Objective： In order to understand whether there is subclinical damage of nerve fibre＇s structure in the brain of metabolic syndrome （MS） with the course longer than 5 years, we used diffusion tensor imaging （DTI） to detect the FA values in the brain. Materials and Methods： 32 participants were categorized into two groups, metabolic syndrome group （15 participants） and control group （17 participants）, ranging from 47 to 69 years old. We measured their body height, weight, blood pressure, blood glucose, blood lipid, scale about nerves function and examined their brain using magnetic resonance imaging （MRI） and magnetic resonance diffusion tensor imaging （DTI）. Then the data were tested by statistical analysis. Results： （1） Compared with the control group, the FA values of posterior limb of internal capsule （PLIC） and corona radiate area （CRA） were lower and significant decline was found （P〈0.0 I）. The FA values of PLIC and CRA with three components of metabolic disorder in MS group were lower and significant decline was found （P〈0.01）. The FA values of CRA with two components of metabolic disorder in MS group were lower and signifcant decline was found （P〈0.05）. （2） Compared with the control group, the FA values of PLIC and CRA with hypertension, diabetes mellitus, hyperlipidemia, obesity in MS group were lower and significant decline was found （P〈0.05）. （3） The multiple regression results： the FA values were negatively associated with hyperlipidemia, hypertension and obesity （r=-0.127, -0.103, -0.012, P〈0.05）. The FA values of CRA were negatively associated with age （r=-0.04, P〈0.05）, and negatively associated withthe course of hypertension （r=--0.013, P〈0.05）. Conclusions： During this study, we found that there were significant changes in nerve fibre＇s structure in the brain of metabolic syndrome group with the course longer than 5 years. The severity of nerve fibre＇s structure in the brain is related to the degree of metabolism dysfunction and the course of metabolism abnormality. Hypertension, hyperlipidemia and obesity were the independent risk factors for the damage of nerve fibre＇s structure.