本文選題：不寧腿綜合征 + 多回波采集的增強(qiáng)T2~*加權(quán)血管成像��； 參考：《南昌大學(xué)》2014年碩士論文

【摘要】：目的：了解不寧腿綜合征(restlesslegssyndrome,RLS)患者腦鐵代謝的變化，探討RLS的發(fā)病機(jī)制及其臨床特征。 方法：采用3.0TMR系統(tǒng)對(duì)RLS患者和年齡、性別相匹配的健康志愿者分別進(jìn)行常規(guī)序列、多回波采集的增強(qiáng)T2*加權(quán)血管成像（enhancedT2-starweightedangiography,ESWAN）序列的顱腦掃描，感興趣區(qū)包括紅核、黑質(zhì)致密部、黑質(zhì)網(wǎng)狀部、丘腦、蒼白球、殼核、尾狀核頭部、齒狀核和腦脊液共9個(gè)部位，應(yīng)用以年齡為協(xié)變量的ANCOVA方法對(duì)兩組之間的腦鐵含量進(jìn)行統(tǒng)計(jì)分析。 結(jié)果：35例RLS患者及35例年齡、性別相匹配的健康志愿者被納入本項(xiàng)研究。RLS患者和健康志愿者右側(cè)感興趣區(qū)的腦鐵含量多低于左側(cè)，，但左右兩側(cè)差異無明顯統(tǒng)計(jì)學(xué)意義（P0.05）。RLS患者腦內(nèi)雙側(cè)感興趣區(qū)的鐵含量明顯低于健康對(duì)照者，尤其是紅核（F=8.372，P=0.005）、黑質(zhì)致密部（F=8.741，P=0.004）、黑質(zhì)網(wǎng)狀部（F=6.525，P=0.013）、蒼白球（F=6.275，P=0.015）、丘腦（F=5.084，P=0.027）、齒狀核（F=5.080，P=0.027）的鐵含量減少有顯著統(tǒng)計(jì)學(xué)意義，并且與不寧腿綜合征嚴(yán)重程度量表評(píng)分呈負(fù)相關(guān)。重度RLS患者腦鐵含量較輕中度RLS及健康對(duì)照者明顯降低（F=3.859,P=0.026到F=30.238,P=0.000）。血清鐵蛋白的變化與腦鐵代謝變化并不完全一致，雖然血清鐵蛋白≥45ug/l組或45ug/l組的RLS患者與健康對(duì)照組比較，雙側(cè)蒼白球（F=5.538，P=0.006）、黑質(zhì)致密部（F=5.309，P=0.007）、黑質(zhì)網(wǎng)狀部（F=3.918，P=0.025）、紅核（F=4.651，P=0.013）的鐵含量明顯降低，差異有統(tǒng)計(jì)學(xué)意義，但血清鐵蛋白≥45ug/l組與45ug/l組間比較，除蒼白球外，所有感興趣區(qū)的腦鐵含量差異無顯著性（P0.05）。ESWAN技術(shù)對(duì)于腦鐵含量的檢測(cè)具有較高的診斷價(jià)值，丘腦區(qū)ROC曲線下面積為0.949，其敏感性和特異性分別為100%、76.2%。結(jié)論：RLS患者腦鐵含量明顯降低，以紅核、黑質(zhì)、蒼白球最為明顯，病情嚴(yán)重時(shí)腦鐵代謝異常的范圍更廣，并且RLS患者的腦鐵含量與不寧腿綜合征嚴(yán)重程度量表評(píng)分呈負(fù)相關(guān)。血清鐵蛋白測(cè)定在RLS診治中的價(jià)值需進(jìn)一步評(píng)估。ESWAN技術(shù)有可能成為RLS患者臨床評(píng)估的重要方法。
[Abstract]:Objective: to investigate the changes of brain iron metabolism in patients with restless legs syndrome (RLS) and to explore the pathogenesis and clinical features of RLS. Methods: a 3.0TMR system was used to scan the brain of RLS patients and healthy volunteers matched by age and sex. The enhanced T2 * weighted angiography (ESWAN) sequences were obtained by multi-echo imaging. The regions of interest included the nucleus erythema and the dense part of substantia nigra. The brain iron content in the substantia nigra reticular part, thalamus, globus pallidus, putamen nucleus, caudate nucleus head, dentate nucleus and cerebrospinal fluid was analyzed by ANCOVA method. Results in this study, 35 RLS patients with RLS and 35 healthy volunteers with age and sex matched were included in this study. The brain iron content in the right region of interest of RLS patients and healthy volunteers was lower than that in the left side. However, there was no significant difference between left and right sides (P0.05). The iron content in bilateral regions of interest in RLS patients was significantly lower than that in healthy controls. In particular, the reduction of iron content in the nucleus rubrum (FV 8.372), the dense part of the substantia nigra (P0. 004), the reticular part of the substantia nigra (FN 6. 525), the globus pallidus (FN 6. 275), the thalamus (FN 5. 084P0. 027) and the dentate nucleus (F5. 080 P0. 027) had significant statistical significance. The content of brain iron in patients with severe RLS was significantly lower than that in patients with mild and moderate RLS and healthy controls (F0. 859%, P < 0. 026, F = 30. 238, P < 0. 000). The changes of serum ferritin were not consistent with the changes of brain iron metabolism, although the serum ferritin 鈮

本文編號(hào)：2055528