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目的:利用氢质子MRS(1H-MRS)探讨重度阻塞性呼吸睡眠暂停综合症(Severe obstructive sleep apnea syndrome,S-OSAS)患者前额叶皮质及岛叶脑代谢产物特征。方法:选择18例S-OSAS患者(S-OSAS组)和15名健康志愿者(HC组)行左侧前额叶皮质及岛叶1H-MRS检查,测量两组左侧前额叶皮质区及岛叶N-乙酰天冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)值。对患S-OSAS累计时间与前额叶皮质及岛叶NAA/Cr作直线相关分析。结果:与正常对照组相比,S-OSAS患者左侧前额叶皮质、岛叶NAA/Cr比值降低,分别为1.43±0.47、1.34±0.06,对照组分别为1.51±0.65、1.45±0.07;S-OSAS组患者左侧前额叶皮质、岛叶Cho/Cr分别为0.90±0.08、1.19±0.13,对照组分别为0.87±0.07、1.09±0.02,两组差异有统计学意义。前额叶皮质及岛叶代谢物NAA/Cr与患S-OSAS累计时间成负相关性(r值分别为-0.965、-0.955,P<0.01)。结论:1H-MRS显示S-OSAS患者前额叶皮质及岛叶病理生理变化,从该区代谢物的改变反应出S-OSAS患者执行及情感功能的异常,其NAA/Cr改变程度与患S-OSAS累计时间相关。
OBJECTIVE: To investigate the characteristics of metabolites in prefrontal cortex and insula by using proton MRS (1H-MRS) in patients with severe obstructive sleep apnea syndrome (S-OSAS). Methods: Eighteen patients with S-OSAS (S-OSAS) and 15 healthy volunteers (HC) underwent left-sided prefrontal cortex and islet 1H-MRS examinations. The left prefrontal cortex and the island Leaf N-acetyl aspartate / creatine (NAA / Cr), choline / creatine (Cho / Cr) value. Straight-line analysis of the cumulative time to S-OSAS versus prefrontal cortex and insula NAA / Cr was performed. Results: Compared with the normal control group, the ratio of NAA / Cr in the left prefrontal cortex and insula decreased in S-OSAS patients (1.43 ± 0.47 and 1.34 ± 0.06, respectively, 1.51 ± 0.65 and 1.45 ± 0.07, respectively; S In the OSAS group, the left frontal cortex and island leaf Cho / Cr were 0.90 ± 0.08 and 1.19 ± 0.13, respectively, while those in the control group were 0.87 ± 0.07 and 1.09 ± 0.02, respectively. The differences between the two groups were statistically significant. NAA / Cr, a metabolite of prefrontal cortex and insula, was negatively correlated with the cumulative time of S-OSAS (r = -0.965, -0.955, P <0.01). H-MRS showed the pathophysiological changes of prefrontal cortex and insula in S-OSAS patients. The changes of metabolites in S-OSAS patients reflected the executive and emotional dysfunction of S-OSAS. The changes of NAA / Cr and S- OSAS cumulative time related.