河北医科大学学报

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阻塞性睡眠呼吸暂停低通气综合征患者髓鞘与轴突的损伤研究

  

  1. 河北医科大学第二医院医学影像科,河北 石家庄 050000
  • 出版日期:2016-04-25 发布日期:2016-05-18
  • 作者简介:曹岂溱( 1986- ),男,湖北十堰人,湖北省十堰市太 和医院医师,医学硕士,从事医学影像诊断研究。
  • 基金资助:
    河北省医学科学研究重点课题( 20150681 )

Myelin and axonal injury in patients with obstructive sleep apneahypopnea syndrome

  1. Department of Medical imaging, the Second Hospital of Hebei Medical Universitay, Shijiazhuang 050000, China
  • Online:2016-04-25 Published:2016-05-18

摘要: [摘要] 目的 应用磁共振扩散张量成像( diffusiontensorimaging , DTI )评价阻塞性睡眠呼吸暂停低通气综合
征( obstructivesleepapnea-hypopneasyndrome ,
OSAHS )患者脑白质髓鞘和轴突的损伤。方法 收集 OSAHS 患者
26 例,以及与 OSAHS 组年龄、性别相匹配的正常志愿者 22 例, 2 组均为男性,行常规颅脑磁共振成像( magnetic
resonanceimaging , MRI )扫描及 DTI 扫描。用 DTIStudio 软件和基于 Matlab 平台的 SPM8 和 REST 软件对所采
集的图像进行后处理,并通过基于体素的分析( voxel-basedanalysis , VBA )方法分析,观察 OSAHS 组患者轴向扩
散系数(
axialdiffusivity , AD )及径向扩散系数( radialdiffusivity ,
RD )相对于正常对照组的变化,得出 2 组差异有统
计学意义的脑区位置以及簇体积。结果 与正常对照组比较, OSAHS 组患者部分脑区 AD 与 RD 值显著减低(
P <
0.01 ), AD 值下降的区域主要位于额叶及顶叶皮质、后扣带回、脑干、腹外侧核、胼胝体、背侧丘脑、海马及小脑等,
RD 值下降的区域主要位于额叶、顶叶及颞叶皮质、前扣带回、后扣带回、脑干、腹外侧核、胼胝体、背侧丘脑、海马、
小脑、楔前叶及岛叶等。结论 OSAHS 患者多个脑区 AD 与 RD 值均较正常志愿者明显减低,表明 OSAHS 患者脑
白质髓鞘和轴突存在着广泛的损伤。运用基于体素的全脑分析方法对 DTI 进行分析,可以定性分析脑白质的微结
构,进而评价 OSAHS 患者的脑白质损伤。

关键词: 睡眠呼吸暂停, 阻塞性, 弥散磁共振成像, 轴突, 髓鞘

Abstract: [
Abstract ] Objective Theaim ofthisstudywastoexplorethebrain myelinandaxonal
injuryinpatientswithobstructivesleepapnea-hypopneasyndrome ( OSAHS ) using magnetic
resonancediffusiontensorimaging ( DTI ) .Methods Twenty-sixmalepatientswithOSAHSand
twenty-twomalehealthycontrolsmatchedforageandgenderwereincludedinthisstudy.Two
groupswereallmales.Conventionalbrainmagneticresonanceimaging ( MRI ) andDTIscanswere
performed.TheDTIdatawereprocessedwiththeDTIStudio , thesoftwareofRESTandSPM8
onthe Matlab.Weusedvoxel-basedanalysis ( VBA ) todeterminethedifferencesofaxial
diffusivity ( AD ) andradialdiffusivity (
RD ) valuesbetweentotwogroups.Andatlast , itwas
concludedthebrainreqionsandclustersizeswithstatisticallysignificantdifferencebetweeninthe
twogroups.Results Comparedwiththecontrolgroup , ADandRDvaluesofexperimentalgroup inthebrainregionsweresignificantlydecreased ( P <0.01 ) .TheregionsdecreasedADvalues
weremainlylocatedinthefrontalgyrus , parietallobule , anteriorcingulate , posteriorcingulate ,
brainstem , ventrallateralnucleus , corpuscallosum , hippocampus , cerebellumandsoon.The
regionsofdecreasedRDvaluesweremainlylocatedinthefrontalgyrus , parietallobule , temporal
lobe , posteriorcingulate , brainstem , ventrallateralnucleus , corpuscallosum , hippocampus ,
cerebellum , insula , precuneusandsoon.Conclusion TheADandRDvaluesofmultiplebrain
regionswithOSAHSpatientsweresignificantlylowerthanthoseinnormalvolunteers , which
confirmedthatthewhitematterhadawiderangeofdamage.Thewhitemattermicrostructure
couldbequalitativelyanalyzedusingDTIbasedontheVBA method , whichcouldevaluatebrain
whitematterlesioninOSAHSpatiens

Key words: sleepapnea, obstructive , diffusion magneticresonanceimaging , axons ;
myelinsheath