發(fā)布時(shí)間：2018-01-21 04:58

  本文關(guān)鍵詞： 原發(fā)性月經(jīng)痛 磁共振成像 大腦皮層厚度分析 基于體素的形態(tài)學(xué)分析 慢性痛　出處：《西安電子科技大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：原發(fā)性月經(jīng)痛作為一種在月經(jīng)周期中常常引起痙攣痛,同時(shí)增加疼痛的敏感性的婦科障礙性疾病。原發(fā)性月經(jīng)痛的特點(diǎn)是月經(jīng)持續(xù)一到三天。普遍的原發(fā)性月經(jīng)痛患者在青少年女性患病人群中占有較大的比例。2005年報(bào)道稱15%的青少年女性經(jīng)歷嚴(yán)重的月經(jīng)痛,同時(shí)導(dǎo)致短期的缺勤。原發(fā)性月經(jīng)痛作為一種婦科的障礙性疾病,嚴(yán)重的影響到女性的生活質(zhì)量并帶來巨大的醫(yī)療負(fù)擔(dān)。近些年來,由于醫(yī)學(xué)成像技術(shù)的蓬勃發(fā)展,特別是核磁共振成像技術(shù)和正電子發(fā)射計(jì)算機(jī)斷層顯像技術(shù)的廣泛應(yīng)用,已有許多關(guān)于原發(fā)性月經(jīng)痛的研究。研究表明,原發(fā)性月經(jīng)痛患者是由于大腦中涉及疼痛信息傳遞,更高層次的感覺處理,情感調(diào)節(jié)的區(qū)域灰質(zhì)降低;涉及疼痛調(diào)制和內(nèi)分泌的調(diào)控的區(qū)域灰質(zhì)增加;同時(shí)在涉及疼痛處理區(qū)域代謝增加;涉及感覺運(yùn)動(dòng)區(qū)域的代謝減小。然而,這些研究大部分是基于PET和VBM的研究,很少有針對(duì)患者大腦皮層厚度異常變化的研究。因此,本論文利用核磁共振成像技術(shù),研究原發(fā)性月經(jīng)痛患者灰質(zhì)解剖結(jié)構(gòu),包括大腦皮層厚度,灰質(zhì)密度,皮下體積的異常變化。首先,采用CTA和VBM這些常用的分析模式來分析原發(fā)性月經(jīng)痛患者與正常對(duì)照組,在月經(jīng)期大腦區(qū)域灰質(zhì)的異常變化。利用相關(guān)性分析和回歸分析的方法,得到具有顯著性相關(guān)的大腦異常變化區(qū)域,包括:頂葉皮質(zhì),楔前葉,上額葉皮質(zhì),后中央回,腦島皮質(zhì),楔葉,后扣帶,中額眶回,右后扣帶,旁海馬皮質(zhì),上顳葉皮質(zhì),前中央回,中顳葉皮質(zhì)。此外,皮下體積分析發(fā)現(xiàn)顯著性的差異,包括:左側(cè)尾狀核,左側(cè)丘腦,左側(cè)杏仁核,及其間腦。這些結(jié)構(gòu)構(gòu)成的腦網(wǎng)絡(luò)有助于進(jìn)一步了解原發(fā)性月經(jīng)痛的在神經(jīng)方面的發(fā)病機(jī)制,并且表明在大腦的不同模態(tài)下分析原發(fā)性月經(jīng)痛的病理機(jī)制更深層次的研究具有可行性。其次,基于體素的形態(tài)測(cè)量學(xué)分析探究原發(fā)性月經(jīng)痛患者灰質(zhì)變化。結(jié)果發(fā)現(xiàn):軀體感覺運(yùn)動(dòng)區(qū),左側(cè)腦島區(qū)域,左側(cè)額眶區(qū)域,中扣帶區(qū)域和小腦區(qū)域。此外,這些區(qū)域與先前的相關(guān)研究的區(qū)域部分重疊。因此,這些研究結(jié)果表明原發(fā)性痛經(jīng)患者灰質(zhì)的異常變化,并且為揭示原發(fā)性月經(jīng)痛在大腦區(qū)域灰質(zhì)異常變化下發(fā)病機(jī)制提供了進(jìn)一步的驗(yàn)證。
[Abstract]:Primary menstrual pain as a kind of menstrual cycle often causes spasmodic pain. A gynecological disorder that increases the sensitivity of pain at the same time. Primary menstrual pain is characterized by one to three days of menstruation. In 2005, it was reported that 15% of teenage women experienced severe menstrual pain. At the same time lead to short-term absence. Primary menstrual pain as a gynaecological disorder, seriously affect the quality of life of women and bring a huge medical burden in recent years. Due to the rapid development of medical imaging technology, especially the wide application of magnetic resonance imaging and positron emission computed tomography, there have been many studies on primary menstrual pain. Primary menstrual pain patients are due to the brain involved in pain information transmission, a higher level of sensory processing, emotional regulation of the gray matter in the region; Increased gray matter in areas involved in pain modulation and endocrine regulation; At the same time, metabolism increased in the pain management area; However, most of these studies are based on PET and VBM studies, and there are few studies on abnormal changes in cortical thickness in patients. In this paper, MRI was used to study the anatomical structure of gray matter in patients with primary menstrual pain, including the abnormal changes of cerebral cortex thickness, gray matter density and subcutaneous volume. CTA and VBM were used to analyze the abnormal changes of gray matter in menstrual region of patients with primary menstrual pain and normal controls. Correlation analysis and regression analysis were used. The abnormal regions of brain were obtained, including parietal cortex, precuneiform cortex, upper frontal cortex, posterior central gyrus, insular cortex, cuneate lobe, posterior cingulate band, middle frontal orbital gyrus, right posterior cingulate zone, and para-hippocampal cortex. In addition, subcutaneous volume analysis showed significant differences, including: left caudate nucleus, left thalamus, left amygdala. These structures form a brain network that helps to further understand the neurogenesis of primary menstrual pain. It also shows that it is feasible to analyze the pathological mechanism of primary menstrual pain in different modes of brain. Secondly. To explore the changes of gray matter in patients with primary menstrual pain based on morphometric analysis of voxel. The results showed that somatosensory motor area, left cerebral islet region, left frontal orbital region, middle cingulate zone and cerebellar area. These areas overlap with those of previous studies. Therefore, these findings suggest abnormal changes in gray matter in patients with primary dysmenorrhea. It also provides further evidence to reveal the pathogenesis of primary menstrual pain under abnormal changes of gray matter in the brain region.
【學(xué)位授予單位】：西安電子科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R711.51

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