發(fā)布時間：2018-02-26 15:11

  本文關(guān)鍵詞： 腰椎間盤突出癥 下腰痛 基于體素形態(tài)學 灰質(zhì)　出處：《川北醫(yī)學院》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討椎間盤源性下腰痛患者腦灰質(zhì)體積的變化,以及與疼痛程度、病程的關(guān)系,進而了解椎間盤源性下腰痛的腦神經(jīng)機制。方法:根據(jù)納入和排除標準選取出22例椎間盤源性下腰痛(Low back pain,LBP)患者(LBP組)和22名健康對照組(Health control,HC組)志愿者(HC組),對所有受試者進行疼痛程度視覺模擬評分(Visual analog scale,VAS)以及三維T1加權(quán)快速擾相梯度回波(Fast spoiled gradient recall,FSPGR)序列結(jié)構(gòu)像數(shù)據(jù)采集。然后采用基于MATLAB 2010平臺的SPM8及REST 1.8軟件包對數(shù)據(jù)進行如下處理:(1)對所有受試者的圖像進行預處理后,采用兩獨立樣本t檢驗比較LBP組和HC組大腦灰質(zhì)體積(Gray matter volume,GMV)的差異,單體素閾值取P0.001,多重比較校正采用cluster水平FWE校正。(2)將灰質(zhì)體積有差異的腦區(qū)作為感興趣區(qū),對感興趣區(qū)灰質(zhì)體積與LBP組患者視覺模擬評分(Visual analog scale,VAS)及病程進行偏相關(guān)分析,并控制年齡、性別的影響。結(jié)果:(1)與HC組相比,LBP組患者大腦皮層多個腦區(qū)灰質(zhì)體積減小,包括右側(cè)額上回、左側(cè)額內(nèi)側(cè)回、左側(cè)直回、右側(cè)顳上回、右側(cè)顳中回、右側(cè)島葉以及右側(cè)額下回(P0.001,FWEc校正);無灰質(zhì)體積增大的區(qū)域。(2)上述具有統(tǒng)計學差異腦區(qū)的灰質(zhì)體積與VAS評分及病程均未見明顯相關(guān)性(P0.05)。結(jié)論:慢性椎間盤源性LBP可引起廣泛的腦功能區(qū)GMV的減低,這些腦區(qū)主要涉及感覺、認知及情緒,一定程度上揭示了慢性椎間盤源性LBP的腦神經(jīng)機制。
[Abstract]:Objective: to investigate the changes of gray matter volume in patients with low back pain caused by intervertebral disc, and the relationship between the volume of gray matter and the degree of pain and the course of disease. Methods: according to the criteria of inclusion and exclusion, 22 patients with low back pain (LBP group) and 22 healthy controls (control group HC) were selected. Visual analog scale scale (VAS) and 3D T1 weighted Fast spoiled gradient echo (FSPGR) sequence were used to collect the structural image data of all subjects. Then the logarithm of SPM8 and REST 1.8 software package based on MATLAB 2010 was used. According to the following processing: 1) after preprocessing the images of all the subjects, Two independent t-test samples were used to compare the difference of gray matter volume between LBP group and HC group. The threshold value of monomeric substance was taken as P0.001, and the cluster level FWE correction was used for multiple comparison correction. The partial correlation analysis of gray matter volume in the area of interest with visual analog scalevolume and course of disease in LBP group was carried out, and the influence of age and sex was controlled. Results compared with HC group, the gray matter volume of multiple cerebral cortex regions in LBP group decreased. Including right superior frontal gyrus, left medial frontal gyrus, left straight gyrus, right superior temporal gyrus, right middle temporal gyrus, Right insular lobe and right inferior frontal gyrus P0.001FWEc correction; no increase of gray matter volume.) there is no significant correlation between gray matter volume and VAS score and course of disease. Conclusion: chronic discogenic LBP can be used. Causing a reduction in GMV in a wide range of brain functional areas, These brain regions are mainly involved in sensation, cognition and emotion, which to some extent reveal the brain neural mechanism of chronic discogenic LBP.
【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R681.5

【參考文獻】

相關(guān)期刊論文 前7條

1 蔣元明;黃建強;李宗芳;趙衛(wèi);張振光;謝偉;;原發(fā)性三叉神經(jīng)痛患者小腦灰質(zhì)體積變化[J];武漢大學學報(醫(yī)學版);2015年06期

2 李博;吉婷婷;余成新;;慢性疼痛的靜息態(tài)功能磁共振成像研究進展[J];中國疼痛醫(yī)學雜志;2015年07期

3 陳俊;劉波;劉峴;黃燕;;慢性腰背痛患者前扣帶回功能連接的fMRI研究[J];中國CT和MRI雜志;2015年05期

4 龔啟勇;呂粟;;功能磁共振成像臨床應用及進展[J];磁共振成像;2014年S1期

5 陳俊;劉波;葉泳松;李曉凡;葛緬;劉峴;龍玉;;慢性腰背痛患者的腦靜息態(tài)功能磁共振成像[J];中國醫(yī)學影像技術(shù);2011年06期

6 王洪偉;李長青;周躍;;腰椎間盤突出癥疼痛發(fā)生機制的研究進展[J];中國矯形外科雜志;2011年07期

7 張蔚婷,羅非,韓濟生;痛覺的腦功能成像研究進展[J];生理科學進展;2001年03期

相關(guān)碩士學位論文 前1條

1 李曉凡;慢性腰痛患者靜息態(tài)腦功能網(wǎng)絡改變的研究[D];廣州中醫(yī)藥大學;2011年

，

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