本文選題：2型糖尿病 + 多模式MRI��； 參考：《南京大學(xué)》2014年碩士論文

【摘要】：目的運(yùn)用3.0T磁共振雙回波同反相位技術(shù)(DEI, dual-echo in-phase and out-of-phase MR imaging)、氫質(zhì)子磁共振波譜分析(1H-MRS, proton magnetic resonance spectroscopy)等多模式MRI方法無(wú)創(chuàng)評(píng)估2型糖尿病患者肝臟、腹部及骨骼肌脂肪分布,并與脂肪代謝相關(guān)臨床指標(biāo)綜合評(píng)價(jià)病程進(jìn)展,探討各因素間相關(guān)性。材料與方法研究對(duì)象選自南京市鼓樓醫(yī)院門診2011年1月至2011年12月新診斷及已診斷2型糖尿病患者共58例,受試者禁食8小時(shí),于同一天分別進(jìn)行人體學(xué)特征檢測(cè)、血生化指標(biāo)檢測(cè)及磁共振多種序列掃描,磁共振掃描用于測(cè)量并計(jì)算肝臟脂質(zhì)含量、骨骼肌細(xì)胞內(nèi)脂質(zhì)含量、骨骼肌細(xì)胞外脂質(zhì)含量及腹壁皮下脂質(zhì)面積、腹腔內(nèi)臟脂質(zhì)面積、腹部脂質(zhì)總面積。將2型糖尿病患者是否合并脂肪肝組間進(jìn)行差異性比較,將肝臟、腹部及骨骼肌不同部位脂質(zhì)含量及臨床資料進(jìn)行單因素和多因素回歸分析。結(jié)果在2型糖尿病患者是否合并脂肪肝分組中,葡萄糖負(fù)荷后2小時(shí)血糖(2hPPG)、腹腔內(nèi)臟脂肪面積(VAT)、腹部脂肪總面積(TA)、雙回波同反相位所測(cè)得肝臟脂肪變指數(shù)(HFF)、肝臟1H-MRS所測(cè)肝臟相對(duì)脂肪含量(RLC)有顯著差異(p0.05)。在脂肪代謝指標(biāo)單因素及多因素回歸分析中顯示,身體質(zhì)量指數(shù)(BMI)與腹部脂肪面積指標(biāo)(VAT、SAT、TA)及肝臟脂肪含量指標(biāo)(HFF、RLC)呈顯著正相關(guān)(P0.01),且對(duì)脂肪面積指標(biāo)(VAT、SAT、TA)有正向影響；2hPPG與VAT、TA呈正相關(guān)(P0.05),且2hPPG對(duì)VAT有正向影響；血清脂肪含量指標(biāo)中,總膽固醇、低密度脂蛋白與VAT、TA呈正相關(guān)(P0.05)；肝功能指標(biāo)中,丙氨酸轉(zhuǎn)氨酶與肝臟脂肪含量(HFF、RLC)均呈正相關(guān)。結(jié)論：對(duì)于2型糖尿病患者治療過(guò)程中,應(yīng)關(guān)注患者脂肪代謝,積極并及早預(yù)防、治療異位脂質(zhì)的堆積、脂肪肝等脂肪代謝紊亂性疾病,因脂肪含量與血糖、血脂、肝功能指標(biāo)明顯相關(guān),而利用3.0T磁共振的相關(guān)技術(shù)如雙回波同反相位技術(shù)及磁共振波譜技術(shù)能更好的定量檢測(cè)身體中的異位脂質(zhì)。
[Abstract]:Objective to evaluate the distribution of fat in liver, abdomen and skeletal muscle of patients with type 2 diabetes mellitus (DM) by using 3.0T dual-echo imaging technique, dual-echo in-phase and out-of-phase Mr imaging technique and proton magnetic resonance spectroscopy (HNMR). Methods 1H-MRS, proton magnetic resonance spectroscopy) and other multimode MRI methods were used to evaluate the fat distribution in liver, abdomen and skeletal muscle of patients with type 2 diabetes mellitus (T2DM). The progress of the disease was evaluated comprehensively with the clinical indexes related to fat metabolism, and the correlation between various factors was discussed. Materials and methods from January 2011 to December 2011, 58 newly diagnosed and diagnosed patients with type 2 diabetes mellitus were selected from the outpatient clinic of Gulou Hospital in Nanjing City. The subjects fasted for 8 hours, and the anthropometric characteristics were tested on the same day. Blood biochemical indexes and MRI scanning were used to measure and calculate liver lipid content, intracellular lipid content, extracellular lipid content of skeletal muscle, subcutaneous lipid area of abdominal wall, and visceral lipid area of abdominal cavity. Total area of abdominal lipids. The difference of type 2 diabetes mellitus patients with fatty liver was compared. The contents of lipids in liver, abdomen and skeletal muscle and clinical data were analyzed by univariate and multivariate regression analysis. Results in the subgroup of type 2 diabetic patients with fatty liver, Two hours after glucose loading, there were significant differences in blood glucose (PPG), visceral fat area (VATA), total abdominal fat area (TAA), liver fat change index (HFF) and liver relative fat content (RLC) measured by 1H-MRS in 2 hours after glucose loading. Univariate and multivariate regression analysis showed that, The body mass index (BMI) was positively correlated with the abdominal fat area index (VATA SATTAA) and the liver fat content index (HFFN RLC), and had a positive correlation with the fat area index (VATSATTAA), and 2hPPG had a positive effect on VAT. Total cholesterol, low density lipoprotein (LDL) and VATTA were positively correlated (P 0.05), and alanine aminotransferase (alt) was positively correlated with liver fat content (HFFN RLC). Conclusion: in the course of treatment of type 2 diabetes mellitus, attention should be paid to the fat metabolism of the patients, to prevent and prevent ectopic lipid accumulation, fatty liver and other disorders of fat metabolism due to fat content and blood sugar, blood lipid. The liver function parameters were significantly correlated, and the correlation techniques of 3.0T MRI, such as dual-echo in-phase technique and magnetic resonance spectroscopy (MRI), could be used to quantitatively detect the ectopic lipid in the body.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R587.1;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 梁長(zhǎng)虹;劉于寶;張忠林;謝淑飛;王秋實(shí);;脂肪肝MR氫質(zhì)子波譜成像定量分析的初步研究[J];中華放射學(xué)雜志;2007年01期

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本文編號(hào)：1886760