轻度认知功能障碍患者认知功能与氢质子磁共振波谱的相关性

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摘要目的探讨轻度认知功能障碍（MCI）患者认知功能与氢质子磁共振波谱（1H-MRS）的相关性。方法选取2020年1月至12月在沈阳市精神卫生中心住院及门诊就诊的20 例MCI 患者作为MCI 组，选取同期在医院住院和门诊就诊的15 例阿尔茨海默病（AD）患者作为AD 组，选取同期认知功能正常的20 例老年志愿者作为对照组。对三组研究对象进行认知功能和1H-MRS 检查，测量三组的简易智能状态评价量表（MMSE）、蒙特利尔认知评估量表（MoCA）评分、双侧海马N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌醇（MI）与肌酸（Cr）的比值，比较各组间的NAA/Cr、MI/Cr、Cho/Cr 差别，分析各组MMSE、MoCA 评分和代谢物比值的相关性。结果 MCI 组患者的左侧海马NAA/Cr 高于AD 组，MCI 组、AD 组患者的左侧海马NAA/Cr 均低于对照组，差异有统计学意义（P＜0.05）；MCI组患者的双侧海马MI/Cr 均低于AD 组，MCI 组、AD 组患者的双侧海马MI/Cr 均高于对照组，差异有统计学意义（P＜0.05）；三组的右侧海马NAA/Cr 比较，差异无统计学意义（P＞0.05）；三组的双侧海马Cho/Cr 比较，差异无统计学意义（P＞0.05）。MMSE 评分与左侧海马NAA/Cr 呈正相关（r=0.618，P＜0.01）；MMSE 评分与双侧海马MI/Cr 呈负相关（r 左侧=-0.552，P 左侧＜0.01，r 右侧=-0.462，P 右侧＜0.01）；MoCA 评分与双侧海马NAA/Cr 呈正相关（r 左侧=0.669，P 左侧＜0.01，r 右侧=0.278，P 右侧＜0.05）；MoCA 评分与双侧海马MI/Cr 呈负相关（r 左侧=-0.600，P 左侧＜0.01，r 右侧=-0.477，P 右侧＜0.01）；MoCA 评分与左侧海马Cho/Cr 呈正相关（r=0.322，P＜0.05）。结论 MMSE 、MoCA 评分与代谢物比值存在相关性，1H-MRS 结合认知功能测验可能有助于MCI 和AD 的早期诊断。

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	张云

关键词 ：轻度认知功能障碍, 阿尔茨海默病, 氢质子磁共振波谱, 神经心理学测验

Abstract：Objective To investigate the correlation between cognitive function and hydrogen proton magnetic resonance (1H-MRS) in patients with mild cognitive impairment (MCI). Methods Twenty patients with MCI who were hospitalized and outpatient in Shenyang Mental Health Center from January to December 2020 were selected as the MCI group，15 patients with Alzheimer′s disease (AD) who were hospitalized and outpatient during the same period were selected as the AD group，and twenty elderly volunteers with normal cognitive function were selected as the control group.The cognitive function and 1H-MRS of the subjects in the three groups were examined，and the mini-mental state examination (MMSE)，Montreal cognitive assessment scale (MOCA) scores and the ratio of N-acetyl aspartic acid (NAA)，choline containing compounds (Cho)，myo-inositol compound (MI) and creatine compound (Cr) in the bilateral hippocampus of the three groups were measured. The differences of NAA/Cr，MI/Cr and Cho/Cr among the groups were compared，and the correlation between MMSE and MOCA scores and the ratio of metabolites in each group was analyzed. Results The NAA/Cr of left hippocampus in MCI group was higher than that in AD group，and the NAA/Cr of left hippocampus in MCI group and AD group was lower than that in control group，the differences were statistically significant (P＜0.05). The MI/Cr of bilateral hippocampal in MCI group was lower than that of AD group，and the MI/Cr of bilateral hippocampal in MCI group and AD group was higher than that of control group，with statistical significances(P＜0.05). There was no significant difference in NAA/Cr of right hippocampus among the three groups (P＞0.05). There was no statistical significance in Cho/Cr of bilateral hippocampus among the three groups (P＞0.05). MMSE score was positively correlated with NAA/Cr in left hippocampus(r=0.618，P＜0.01). MMSE score was negatively correlated with MI/Cr in bilateral hippocampus (rleft=-0.552，Pleft＜0.01，rright=-0.462，Pright＜0.01). MoCA score was positively correlated with bilateral hippocampal NAA/Cr (rleft=0.669，Pleft＜0.01，rright=0.278，Pright＜0.05). MoCA score was negatively correlated with MI/Cr in bilateral hippocampus (rleft=-0.600，Pleft＜0.01，rright=-0.477，Pright＜0.01). MoCA score was positively correlated with Cho/Cr in the left hippocampus (r=0.322，P＜0.05). Conclusion MMSE and MOCA scores were correlated with the ratio of metabolites. 1H-MRS combined with cognitive function test was may helpful for the early diagnosis of MCI and AD.

Key words： Mild cognitive impairment； Alzheimer&prime s disease； 1H-magnetic resonance spectroscopy； Neuropsychological test

收稿日期: 2021-06-22

作者简介: 张云（1982-），女，河北邢台人，硕士，研究方向：精神病学

引用本文:

张云. 轻度认知功能障碍患者认知功能与氢质子磁共振波谱的相关性[J]. 中国当代医药, 2022, 29(1): 112-115.
ZHANG Yun. Correlation between cognitive function and hydrogen magnetic resonance spectrum in patients with mild cognitive impairment. 中国当代医药, 2022, 29(1): 112-115.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2022/V29/I1/112

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