發(fā)布時間：2018-04-13 13:19

  本文選題：動脈自旋標(biāo)記法 + 阻塞性睡眠呼吸暫停低通氣綜合征��； 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的利用動脈自旋標(biāo)記法(ASL)對阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者在靜息狀態(tài)下腦血流灌注的改變進行量化分析,進一步探索分析OSAHS患者腦血流灌注改變與腦功能之間的關(guān)系。材料與方法1.招募了2013年8月至2016年1月在我院呼吸科就診的男性重度OSAHS患者30例及同期年齡、教育程度相匹配的男性正常睡眠者(對照組)30例,采集靜息狀態(tài)下的偽連續(xù)性動脈自旋標(biāo)記(PCASL)腦部序列數(shù)據(jù),經(jīng)過數(shù)據(jù)后處理得出局部腦血流量(rCBF)。2.在腦功能數(shù)據(jù)掃描當(dāng)天,所有受試者均接受蒙特利爾認知(Montreal cognitive function,MoCA)評估量表評估及愛潑沃斯嗜睡量表(Epworth sleepiness scale,ESS)評估。3.采用MATLAB2010a平臺上的ASL-tbx軟件將原始數(shù)據(jù)進行預(yù)處理;采用REST plus軟件對患者組與對照組各腦區(qū)間rCBF值進行組間兩樣本t檢驗,得到有統(tǒng)計學(xué)差異的腦區(qū);然后采用IBM SPSS19.0統(tǒng)計軟件對rCBF值有差異的腦區(qū)與臨床量表評分進行Pearson相關(guān)性分析。結(jié)果1.OSAHS患者組與正常對照組(GSs)的年齡及受教育年限沒有明顯的統(tǒng)計學(xué)差異(P0.05);OSAHS患者組的快速動眼睡眠階段占總睡眠時間百分比、總睡眠時間及最低SaO2較正常對照組更低,AHI值、SaO290%值及微覺醒指數(shù)明顯高于對照組(P0.05)。2.與GSs相比,OSAHS組的左側(cè)小腦后葉、左側(cè)顳葉、右側(cè)額中回及雙側(cè)海馬旁回的rCBF減低;rCBF增高的腦區(qū)主要位于雙側(cè)額上回。3.右側(cè)海馬旁回的rCBF值與覺醒指數(shù)呈正相關(guān)(r=0.365,P=0.047),左側(cè)額上回rCBF值與最長呼吸暫停時間呈正相關(guān)(r=0.422,P=0.020),右側(cè)額上回rCBF值與最長呼吸暫停時間呈正相關(guān)(r=0.447,P=0.013)。結(jié)論1.OSAHS患者存在左側(cè)小腦后葉、左側(cè)顳葉、右側(cè)額中回、雙側(cè)海馬旁回及雙側(cè)額上回等多個腦區(qū)的腦血流灌注異常。2.這些灌注異常腦區(qū)的rCBF值與臨床量表評分間存在著相關(guān)性,推測這些腦區(qū)的rCBF的改變可能是OSAHS患者臨床癥狀產(chǎn)生的主要機制之一。
[Abstract]:Objective to analyze quantitatively the changes of cerebral blood flow perfusion in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) under resting state by arterial spin labeling (ASL).To explore the relationship between cerebral blood flow perfusion and brain function in patients with OSAHS.Materials and methods 1.From August 2013 to January 2016, 30 male patients with severe OSAHS and 30 men with matched age and education were recruited (control group, 30 cases).The brain sequence data of pseudo-continuous arterial spin labeling (PCASL) under resting state were collected and the local cerebral blood flow (rCBFV) was obtained by processing the data.On the same day of brain function data scanning, all subjects were assessed with Montreal cognitive function Mocha and Epworth sleepiness scale-ESS.3.The original data were preprocessed by ASL-tbx software on MATLAB2010a platform, and the REST plus software was used to test the rCBF value of each brain interval between the patients group and the control group, and the brain regions with statistical difference were obtained.Then IBM SPSS19.0 software was used to analyze the Pearson correlation between the brain regions with different rCBF values and the clinical scale scores.Results there was no significant difference in age and years of education between the 1.OSAHS group and the normal control group. The REM sleep stage in the OSAHS group was as a percentage of the total sleep time.The total sleep time and minimum SaO2 were significantly lower than those of the control group (P < 0.01). The Sao _ (290%) value and the microarousal index were significantly higher than those in the control group (P < 0.05).Compared with GSs group, the areas with decreased rCBF in left posterior cerebellar lobe, left temporal lobe, right middle frontal gyrus and bilateral pariprahippocampal gyrus were mainly located in bilateral superior frontal gyrus.The rCBF value of right parahippocampal gyrus was positively correlated with the arousal index, the rCBF value of left superior frontal gyrus was positively correlated with the longest apnea time, the rCBF value of right superior frontal gyrus was positively correlated with the longest apnea time, and the rCBF value of right superior frontal gyrus was positively correlated with the longest apnea time.Conclusion in patients with 1.OSAHS, the cerebral blood perfusion is abnormal in the left posterior cerebellar lobe, left temporal lobe, right middle frontal gyrus, bilateral pariprahippocampal gyrus and bilateral superior frontal gyrus.There is a correlation between the rCBF values of these abnormal cerebral regions and the clinical scale scores. It is speculated that the changes of rCBF in these brain regions may be one of the main mechanisms of clinical symptoms in OSAHS patients.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R766;R445.2

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本文編號：1744678