本文選題：非神經(jīng)精神性狼瘡 + 靜息態(tài)功能磁共振��； 參考：《南昌大學》2017年碩士論文

【摘要】：目的:采用靜息態(tài)功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)基于體素度中心度(voxel-wise degree centrality,DC)分析方法,探討系統(tǒng)性紅斑狼瘡(systemic lupus erythematosus,SLE)患者出現(xiàn)神經(jīng)精神癥狀之前(非神經(jīng)精神狼瘡)腦功能網(wǎng)絡連接屬性的改變,以期找到早期診斷神經(jīng)精神性狼瘡(neuropsychiaric systemic lupus erythematosus,NPSLE)的線索以及進一步探明NPSLE的發(fā)病機制。方法:首先收集24例臨床確診的無明顯神經(jīng)精神癥狀的系統(tǒng)性紅斑狼瘡患者(非NPSLE組)及24例性別、年齡與非NPSLE組相匹配的健康對照者(health controls,HCs組)進行rs-fMRI及T1高清結構像掃描,并記錄所有非NPSLE患者的臨床資料,計算系統(tǒng)性紅斑狼瘡疾病活動性指數(shù)(systemic lupus erythematosus disease activity index,SLEDAI)評分。然后在Matlab 2012a平臺上應用DPABI軟件中的功能磁共振處理助手DPARSF進行數(shù)據(jù)預處理,并采用基于體素的DC方法(矩陣相關系數(shù)閾值為0.25)分析rs-fMRI數(shù)據(jù)。最后分別統(tǒng)計體素水平的DC及人口學、臨床參數(shù)的組間(非NPSLE組與HCs組)差異,并將非NPSLE組差異腦區(qū)的DC值與各臨床參數(shù)進行相關分析。結果:1、與HCs組比較,非NPSLE組DC值下降的腦區(qū)包括右側(cè)額內(nèi)側(cè)回/額上回/額中回、右側(cè)尾狀核,左側(cè)額中回/額下回、左側(cè)前扣帶回、左側(cè)小腦后葉,DC值增高的腦區(qū)為右側(cè)中央后回/楔前葉/中央旁小葉。2、相關性分析發(fā)現(xiàn),非NPSLE組右側(cè)額內(nèi)側(cè)回/額上回/額中回DC值與補體C3濃度呈正相關。結論:1、本研究發(fā)現(xiàn),SLE患者在出現(xiàn)神經(jīng)精神癥狀之前、頭顱cMRI檢查陰性時,就已經(jīng)存在腦功能改變,推測其可能已經(jīng)處于亞臨床NPSLE階段,因此有必要對SLE患者進行早期評估和干預,以防止腦功能發(fā)生進一步損害,最終導致NPSLE的發(fā)生。2、本研究還發(fā)現(xiàn),非NPSLE組右側(cè)額內(nèi)側(cè)回/額上回/額中回的DC值與補體C3濃度呈正相關,提示非NPSLE患者部分腦區(qū)的功能損傷可能與補體C3有關,這一發(fā)現(xiàn)將有助于我們進一步認識NPSLE的發(fā)病機制,并為早期干預的發(fā)展提供潛在的方向。
[Abstract]:Aim: to use resting state functional magnetic resonance imagingrs-f MRI-based voxel-wise degree centralityDCanalysis method. To investigate the changes of functional network connections in patients with systemic lupus erythematosus before neuropsychiatric symptoms (non-neuropsychiatric lupus). The aim of this study was to find out the clues of early diagnosis of neuropsychiatric lupus systemic lupus erythematosus (NPSLEs) and to further investigate the pathogenesis of NPSLE. Methods: first of all, 24 patients with systemic lupus erythematosus without obvious neuropsychiatric symptoms (non-NPSLE group), 24 patients with sex and healthy controls matched with non-NPSLE group were examined by rs-fMRI and T1 high-definition structural imaging. The clinical data of all non NPSLE patients were recorded and the systemic lupus erythematosus disease activity index (SLEDAI) score was calculated. Based on Matlab 2012a, the rs-fMRI data are preprocessed by DPARSF, a functional magnetic resonance processing assistant in DPABI software, and the rs-fMRI data are analyzed by voxel based DC method (the threshold of matrix correlation coefficient is 0.25). Finally, the differences of DC and demography of voxel level and clinical parameters (non-NPSLE group and HCs group) were analyzed, and the correlation between DC values and clinical parameters in different brain regions in non-NPSLE group was analyzed. Results compared with HCs group, the decreased DC value in non-NPSLE group included right medial frontal gyrus / superior frontal gyrus / middle frontal gyrus, right caudate nucleus, left middle frontal / inferior frontal gyrus, left anterior cingulate gyrus, and left anterior cingulate gyrus. The area with increased DC value in left posterior lobe was right posterior central gyrus / prewedge / paracentral lobule. Correlation analysis showed that DC value in right medial frontal / superior frontal gyrus / middle frontal gyrus was positively correlated with C3 concentration in non-NPSLE group. Conclusion: 1. In this study, we found that brain function changes had already existed in patients with cMRI before they developed neuropsychiatric symptoms. It was speculated that they might be in the stage of subclinical NPSLE. Therefore, it is necessary to carry out early assessment and intervention in patients with SLE in order to prevent further damage to brain function and ultimately lead to the occurrence of NPSLE. The DC value of right medial frontal gyrus / superior frontal gyrus / middle frontal gyrus was positively correlated with complement C3 concentration in non-NPSLE group, suggesting that the functional damage in some brain regions of non-NPSLE patients might be related to complement C3. This finding will help us to further understand the pathogenesis of NPSLE. It also provides a potential direction for the development of early intervention.
【學位授予單位】：南昌大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R593.241;R747.9;R445.2

【參考文獻】

相關期刊論文 前5條

1 蔣小露;程震;張龍江;周巖;柯俊;羅松;鄭罡;張宗軍;;動脈自旋標記技術對系統(tǒng)性紅斑狼瘡患者腦血流量的初步研究[J];醫(yī)學研究生學報;2016年05期

2 王麗娜;張東升;朱佳;李強;李瑋;王涵月;陳佳杰;李永斌;嚴雪嬌;王亞蓉;王瑋;;海洛因依賴者大腦自發(fā)活動強度變化的低頻振幅fMRI研究[J];實用放射學雜志;2014年05期

3 扶瓊,左曉霞,周亞歐,謝艷麗;神經(jīng)精神狼瘡危險因素的臨床分析[J];中華風濕病學雜志;2005年01期

4 謝尚葵,馮樹芳,沈福民;HLA-Ⅱ類基因與狼瘡性器官系統(tǒng)損害的相關性研究[J];中華風濕病學雜志;2000年04期

5 袁國華,魏琴,劉湘源,施桂英;系統(tǒng)性紅斑狼瘡并發(fā)中樞神經(jīng)系統(tǒng)病變的危險因素[J];中華風濕病學雜志;1999年01期

，

本文編號：1821233