【摘要】：目的基于靜息態(tài)功能磁共振成像(rs-f MRI)探討不同血糖水平的新診斷2型糖尿病(T2DM)患者自發(fā)性腦神經(jīng)活動(dòng)的改變及其與認(rèn)知功能的關(guān)系。方法選取2014年7月—2015年10月在陸軍總醫(yī)院內(nèi)分泌科新診斷的T2DM患者41例。以入院時(shí)空腹血糖(FPG)水平進(jìn)行分組,7.0 mmol/L≤FPG11.1 mmol/L為輕度高血糖組(A組,n=21),FPG≥11.1 mmol/L為嚴(yán)重高血糖組(B組,n=20);選取本院同期健康體檢者為健康對(duì)照組(n=21)。采集3組受試者臨床資料,行認(rèn)知功能評(píng)分及rs-f MRI掃描。提取異常腦區(qū)的rs-f MRI分?jǐn)?shù)低頻振幅(fALFF)值,與臨床資料、認(rèn)知功能評(píng)分行相關(guān)性分析。結(jié)果 A、B組FPG、糖化血紅蛋白(HbA_(1c))水平高于健康對(duì)照組,B組FPG、HbA_(1c)水平高于A組(P0.01)。3組認(rèn)知功能評(píng)分比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3組雙側(cè)額上回、后扣帶回/楔前葉、頂下小葉、內(nèi)側(cè)前額葉皮質(zhì)fALFF值均高于全腦平均水平(P0.05)。A、B組左側(cè)額上回、右側(cè)枕中回、右側(cè)小腦后葉、左側(cè)中央前回fALFF值低于健康對(duì)照組,右側(cè)額上回fALFF值高于健康對(duì)照組(P0.05,FDR校正)。B組左側(cè)額中回fALFF值高于A組,右側(cè)中央前回fALFF值低于A組(P0.05,FDR校正)。新診斷T2DM患者右側(cè)小腦后葉fALFF值與胰島素抵抗指數(shù)(HOMA-IR)(r=-0.470,P0.05)、HbA_(1c)(r=-0.348,P0.05)呈負(fù)相關(guān);新診斷T2DM患者右側(cè)中央前回fALFF值與HbA_(1c)(r=-0.518,P0.05)、FPG(r=-0.528,P0.05)呈負(fù)相關(guān);左側(cè)額中回fALFF值與HbA_(1c)(r=0.640,P0.05)、FPG(r=0.738,P0.05)呈正相關(guān)。結(jié)論新診斷T2DM患者在診斷早期已存在右側(cè)小腦后葉、右側(cè)枕中回等腦區(qū)自發(fā)性神經(jīng)活動(dòng)下降;部分腦區(qū)的改變與血糖控制或胰島素抵抗密切相關(guān),這些腦區(qū)的fALFF值進(jìn)一步闡釋了T2DM相關(guān)性認(rèn)知障礙的神經(jīng)生理學(xué)基礎(chǔ)。
[Abstract]:Objective based on resting functional magnetic resonance imaging (rs-f MRI) to investigate the changes of spontaneous cerebral nerve activity in patients with type 2 diabetes mellitus (T2DM) with different blood glucose levels and its relationship with cognitive function. Methods 41 newly diagnosed T2DM patients from July 2014 to October 2015 in Endocrinology Department of Army General Hospital were selected. Fasting blood glucose (FPG) levels were divided into mild hyperglycemia group (group A, n = 21) and severe hyperglycemia group (group B, n = 20) with fasting blood glucose (FPG) of 7. 0 mmol/L 鈮，

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