3.0T磁共振SWI在2型糖尿病脑微出血与认知功能影响的临床研究

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：以脑微出血作为生物学标志物研究2型糖尿病脑病微血管病变，并探讨其在糖尿病认知功能障碍发生中的影响。方法：收集认知功能障碍的2型糖尿病患者30例，及年龄、性别及受教育程度相匹配的无认知功能障碍的2型糖尿病患者30例。记录每位受测试者的MoCA评分总分及各项分值等分。采用SWI扫描记录两组脑微出血（CMBs）灶的分布及数量。结果：在所有57例中发现CMBs病26例，CMBs患病率为45.6%。共发现CMBs灶155个，出血数目及分布以皮层/皮层下区多见，皮层/皮层下区CMBs共有107个，大脑半球深部CMBs 41个，脑干及幕下CMBs 7个，占总数分别为69.0%、26.5%、4.5%。两组CMBs灶发生例数及个数有统计学差异（P＜0.05）。两组CMBs灶在皮层-皮层下区、大脑半球深部发生例数有统计学差异（P＜0.05）。CMBs与MoCA总分、视空间执行能力、注意力、语言能力、抽象能力、记忆力评分呈负相关（P＜0.05）；而与命名能力及定向力评分无相关性（P＞0.05）。结论：脑微出血是影响糖尿病患者认知功能的一个独立因素，并且有随CMBs数目增多，认知功能损害越重的趋势。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘雯文
	刘进才

关键词 ：糖尿病, 2型, 脑出血, 认知障碍, 磁共振成像

Abstract：Objective: To study type 2 diabetic encephalopathy microvascular disease by SWI with cerebral microbleeds(CMBs) as biological markers, and explore the impact of cognitive dysfunction in diabetes. Methods: We recruit patients with type 2 diabetes with cognitive dysfunction by montreal cognitive scale(MoCA) in 30 cases, and patients with type 2 diabetes, having non-recognition dysfunction in 30 cases, which matched by age, sex and education level. Each subject’s MoCA total score and the specific score were recorded, then underwent conventional MRI and SWI scan. The number and location of CMBs on SWI images of two groups were examined. Results: In all 57 cases, 26 cases had CMBs, CMBs prevalence was 45.6%. There were 155 CMBs, the number and distribution of CMBs were common in subcortical/cortical areas, there were 107 CMBs at subcortical/cortical areas, lower hemisphere deep CMBs were 41, brainstem and curtain CMBs were 7, accounting for the total respectively 69.0%, 26.5%, 4.5%. The two groups had significant difference in the number and case of CMBs(P<0.05). The two groups had significant difference in the case of CMBs in difference area of brain(P<0.05). According to Spearman correlation analysis results, the CMBs number was negatively correlated with total MoCA scores, visuospatial skills and execution function scores, attention scores, language scores, abstracting scores and memory scores(P＜0.05). Conclusion: CMBs is an independent factors affecting cognitive function in diabetic patients, and there is a trend that with an increase of the number of CMBs, it leads the more severe cognitive impairment.

Key words： Diabetes mellitus, type 2 Cerebral hemorrhage Cognition disorders Magnetic resonance imaging

收稿日期: 2015-06-20

PACS:	Ｒ743.34
	R587.1
	Ｒ445.2

通讯作者: 刘进才

引用本文:

刘雯文，刘进才. 3.0T磁共振SWI在2型糖尿病脑微出血与认知功能影响的临床研究[J]. 中国临床医学影像杂志, 2016, 27(3): 161-166.
LIU Wen-wen, LIU Jin-cai. 3.0T MRI SWI clinical study of cerebral microbleeds in type 2 diabetes and association with cognitive function. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(3): 161-166.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I3/161

[1]Tiehuis AM, van der Graaf Y, Visseren FL, et al. Diabetes increases atrophy and vascular lesions on brain MRI in patients with symptomatic arterial disease[J]. Stroke, 2008, 39(5): 1600-1603．
[2]Nishikawa T, Ueba T, Kajiwara M, et al. Cerebral microbleeds in patients with intracerebral hemorrhage are associated with pre-vious cerebrovascular diseases and white matter hyperintensity, but not with regular use of antiplatelet agents[J]. Neurol Med Chir, 2009, 49(8): 333-339.
[3]Cheng AL, Batool S, McCreary CR, et al. Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting microbleeds[J]. Stroke, 2013, 44(10): 2782-2786.
[4]Rahman S, Rahman T, Ismail AA, et al. Diabetes-associated macrovasculopathy: pathophysiology and pathogenesis[J]. Diabetes Obes Metab, 2007, 9(6): 767-780.
[5]Churdchomjan W, Kheolamai P, Manochantr S, et al. Comparison of endothelial progenitor cell function in type 2 diabe with good and poor glycemic control[J]. BMC Endocr Disord, 2010, 10(1): 5.
[6]Arden GB, Sidman RL, Arap W, et al. Spare the rod and spoil the eye[J]. Br J Ophthalmol, 2005, 89(6): 764-769.
[7]Wang Q, Pfister F, Dorn-Beineke A, et al. Low-dose erythropoietin inhibits oxidative stress and early vascular changes in the experimental diabetic retina[J]. Diabetologia, 2010, 53(6): 1227-1238.
[8]Rangasamy S, McGuire PG, Das A. Diabetic retinopathy and inflammation: novel therapeutic targets[J]. Middle East Afr J Ophthalmol, 2012, 19(1): 52-59.
[9]Babikian T, Freier MC, Tong KA, et al. Susceptibility weighted imaging: neuropsychologic outcome and pediatric head injury[J]. Pediatr Neurol, 2005, 33(3): 184-194.
[10]Skehan ME, Khan MA, Skehan ME, et al． Spatial relation between microbleeds and amyloid deposits in amyloid angiopathy[J]. Ann Neurol, 2010, 68(4): 545-548．
[11]Ahtiluoto S, Polvikoski T, Peltonen M, et al. Diabetes, Alzheimer disease, and vascular dementia A population-based neuropathologic study[J]. Neurology, 2010, 75(13): 1195-1202.
[12]de la Monte SM, Tong M, Lester-Coll N, et al. Therapeutic rescue of neurodegeneration in experimental type 3 diabetes: Rel-evance to Alzheimer’s disease[J]. J Alzheimers Dis, 2006, 10(1): 89-109.
[13]Hong H, Liu LP, Liao JM, et al. Down regulation of LRPI at the blood-brain in streptozotocin-induced diabetic mice[J]. Neuropharmacology, 2009, 56(6-7): 1054-1059.
[14]Greenberg SM. Cerebral amyloid angiopathy: prospects for clinical diagnosis and treatment[J]. Neurology, 1998, 51(3): 690-694.
[15]Greenberg SM, Vernooij MW, Cordonnier C, et al. Cerebral microbleeds: a guide to detection and interpretation[J]. Lancet Neurol, 2009, 8(2): 165-174.
[16]van Norden AG, van den Berg HA, de Laat KF, et al. Poorer cognitive performance in elderly suffering from cerebral micro-bleeds[J]. Ned Tijdschr Geneeskd, 2012, 156(37): A4813.
[17]Gregoire SM, Smith K, Jager HR, et al. Cerebral microbleeds and long-term cognitive outcome: longitudinal cohort study of stroke clinic patients[J]. Cerebrovasc Dis, 2012, 33(5): 430-435.
[18]Seo SW, Lee BH, Kim EJ, et al. Clinical significance of microbleeds in subcortical vascular dementia[J]. Stroke, 2007, 38(38): 1949-1951.
[19]Yakushiji Y, Nishiyama M, Yakushiji S, et al. Brain microbleeds and global cognitive function in adults without neurological disorder[J]. Stroke, 2008, 39(12): 3323-3328.
[20]邢立红，翟飞，张敬，等. 脑微出血灶与认知功能相关性的磁共振研究[J]. 中华老年心脑血管病杂志，2014，16（3）：287-290.
[21]王瑞，郭庆乐，元小冬，等. 老年认知功能障碍与脑结构CT测量的相关性研究[J]. 实用放射学杂志，2007，23（3）：289-292.
[22]Guo H, Song XW, Matthias H, et al. Evaluation of whole brain health in aging and Alzheimer’s disease: a standard procedure for scoring an MRI-based brain atrophy and lesion index[J]. J Alzheim Dis, 2014, 42(2): 691-703.
[23]Guo H, Song X, Vandorpe R, et al. Evaluation of common structural brain changes in aging and Alzheimer disease with the use of an MRI-based brain atrophy and lesion index: a comparison between T1WI and T2WI at 1.5T and 3T[J]. AJNR, 2014, 35(3): 504 -512.
[24]肖桂荣，孙新芳，王赵伟，等. 脑微出血磁敏感加权成像检出情况及其与认知功能的关系[J]. 中国全科医学，2014，17（21）：2532－2535.
[25]Werring DJ, Frazer DW, Coward LJ, et al. Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI[J]. Brain, 2004, 127(5): 2265-2275.
[26]陈峰，薛建中，陆建明，等．脑微出血与认知功能障碍的临床研究[J]. 中国实用神经疾病杂志，2010，13（23）：1-3.
[27]Nitkuan A, Barrick TR, Charlton RA, et al. Multimodal MRI in cerebral small vessel disease: its relationship with cognition and sensitvity to change over time[J]. Stroke, 2008, 39(7): 1999-2005.
[28]Akoudad S, de Groot M, Koudstaal PJ, et al. Cerebral microbleeds are related to loss of white matter structural integrity[J]. Neurology, 2013, 81(22): 1930-1937.