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目的利用磁共振波谱技术研究急性一氧化碳中毒(ACOP)患者及迟发性脑病(DEACMP)患者海马代谢物数值与正常对照组的差异,探讨其临床意义。方法所有实验者被分为3组:ACOP组17例、DEACMP组43例及正常对照组30名,并按年龄将3组分别分成年轻组(<50岁)和年老组(≥50岁)。所有病例均分别行双侧海马区磁共振波谱检查,采用单体素分辨自旋回波序列的点解析波谱法采集数据,记录双侧海马区氮-乙酰天门冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/Cr值,采用独立样本t检验及单因素方差分析分组进行统计学分析。结果 (1)正常对照组左右两侧海马NAA/Cr、Cho/Cr差异均无统计学意义(年轻组NAA/Cr P=0.558、Cho/Cr P=0.566;年老组NAA/Cr P=0.546、Cho/Cr P=0.894)。(2)年轻组NAA/Cr数值:对照组、ACOP组、DEACMP组数值依次降低,差异有统计学意义(F=4.805,P=0.01)。(3)年轻组Cho/Cr数值依上顺序依次升高,差异有统计学意义(F=5.58,P=0.005)。(4)年老组NAA/Cr:对照组高于ACOP组与DEACMP组,差异有统计学意义(F=3.54,P=0.012);组内比较ACOP组与DEACMP组差异无统计学意义(P=0.512)。(5)年老组Cho/Cr:对照组低于ACOP组与DEACMP组,差异有统计学意义(F=3.931,P=0.026);组内比较对照组与ACOP组、ACOP组与DEACMP组差异均无统计学意义(P=0.684,P=0.479)。结论利用磁共振波谱技术可以准确反映ACOP患者急性期与迟发脑病期海马区代谢变化,为评估病情的严重性与早期诊断及预防DEACMP的发生提供理论支持。
Objective To study the difference of the metabolites of hippocampus in patients with acute carbon monoxide poisoning (ACOP) and patients with late-onset encephalopathy (DEACMP) using magnetic resonance spectroscopy and to find out its clinical significance. Methods All the participants were divided into three groups: 17 in the ACOP group, 43 in the DEACMP group and 30 in the normal control group. The 3 groups were divided into the young group (<50 years) and the old group (≥50 years) . All the cases were examined by magnetic resonance spectroscopy in bilateral hippocampus. Data were collected by single analyte spin echo (SPR) spectrum analysis. The data of NAA / Cr and Cho / Cr values were analyzed by independent sample t-test and one-way analysis of variance (ANOVA). Results (1) NAA / Cr and Cho / Cr in the hippocampus of the left and right sides of the normal control group were not significantly different (NAA / Cr P = 0.558, Cho / Cr P = 0.566; NAA / Cr P = 0.546 , Cho / Cr P = 0.894). (2) NAA / Cr values in young group: The values of control group, ACOP group and DEACMP group decreased in turn, the difference was statistically significant (F = 4.805, P = 0.01). (3) The values of Cho / Cr in young group increased in turn according to the sequence, the difference was statistically significant (F = 5.58, P = 0.005). (4) The NAA / Cr in aged group was higher than that in ACOP group and DEACMP group (F = 3.54, P = 0.012). There was no significant difference between ACOP group and DEACMP group = 0.512). (5) Cho / Cr in aged group was lower than that in ACOP group and DEACMP group (F = 3.931, P = 0.026). There was significant difference between ACOP group, ACOP group and DEACMP group No statistical significance (P = 0.684, P = 0.479). Conclusion Magnetic resonance spectroscopy can accurately reflect the changes of metabolism in the hippocampus of ACOP patients during acute and late encephalopathy stages and provide theoretical support for assessing the severity of the disease and early diagnosis and prevention of DEACMP.