论文部分内容阅读
目的:采用伪连续式动脉自旋标记法(pCASL)MRI对终末期肾病(ESRD)患者的脑灌注变化进行无创性测量,并讨论这种改变与认知功能障碍之间的关系。方法:将40例ESRD患者和40例性别、年龄相匹配的健康志愿者纳入研究,所有受试者进行实验室检查(血红蛋白、血肌酐和尿素)和神经心理学测试[包括数字连接试验-A(NCT-A)、数字符号试验(DST)、焦虑自评量表(SAS)和抑郁自评量表(SDS)],随后行pCASL-MRI检查,测量全脑、脑灰质和脑白质区的脑血流量(CBF)。对两组间的各项资料进行统计学分析。结果:ESRD组全脑、灰质和白质的CBF值均明显高于正常对照组,差异有统计学意义(P<0.01);两组间DST、SAS和SDS分值的差异有统计学意义(P<0.05),而NCT-A分值的差异无统计学意义(P>0.05)。ESRD患者的全脑、灰质和白质的CBF值与血红蛋白含量间均呈明显负相关关系(P<0.01),与DST分值亦呈负相关关系(P<0.05);血红蛋白含量与DST分值间呈明显正相关关系(P<0.05)。而血肌酐和尿素含量与各神经心理学量表分值间无显著相关关系(P>0.05)。结论:ESRD患者的认知功能较健康人群减低,这种改变与其脑组织血流灌注以及血红蛋白含量具有显著相关性。
PURPOSE: To evaluate the noninvasive measurement of cerebral perfusion changes in patients with end-stage renal disease (ESRD) using pseudo-continuous arterial spin-labeling (pCASL) MRI and discuss the relationship between such changes and cognitive dysfunction. METHODS: Forty ESRD patients and 40 healthy, age-matched healthy volunteers were enrolled in the study. All subjects underwent laboratory tests (hemoglobin, serum creatinine, and urea) and neuropsychological tests [including digital connectivity test-A (NCT-A), DST, SAS and SDS, and then the pCASL-MRI was used to measure the changes of whole brain, gray matter and white matter Cerebral blood flow (CBF). The data between the two groups were statistically analyzed. Results: The CBF values of whole brain, gray matter and white matter in ESRD group were significantly higher than those in normal control group (P <0.01). The differences of DST, SAS and SDS between the two groups were statistically significant (P <0.05), while there was no significant difference in NCT-A score (P> 0.05). CBF values of whole brain, gray matter and white matter in ESRD patients were negatively correlated with hemoglobin content (P <0.01), and also negatively correlated with DST scores (P <0.05); between hemoglobin content and DST score Showed a significant positive correlation (P <0.05). There was no significant correlation between serum creatinine and urea content and neuropsychological scores (P> 0.05). CONCLUSION: The cognitive function of patients with ESRD is lower than that of healthy people. This change has a significant correlation with the perfusion of brain tissue and the content of hemoglobin.