本文關鍵詞： 腰椎間盤突出癥 下腰痛 基于體素形態(tài)學 灰質　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體積的變化,以及與疼痛程度、病程的關系,進而了解椎間盤源性下腰痛的腦神經機制。方法:根據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加權快速擾相梯度回波(Fast spoiled gradient recall,FSPGR)序列結構像數據采集。然后采用基于MATLAB 2010平臺的SPM8及REST 1.8軟件包對數據進行如下處理:(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)將灰質體積有差異的腦區(qū)作為感興趣區(qū),對感興趣區(qū)灰質體積與LBP組患者視覺模擬評分(Visual analog scale,VAS)及病程進行偏相關分析,并控制年齡、性別的影響。結果:(1)與HC組相比,LBP組患者大腦皮層多個腦區(qū)灰質體積減小,包括右側額上回、左側額內側回、左側直回、右側顳上回、右側顳中回、右側島葉以及右側額下回(P0.001,FWEc校正);無灰質體積增大的區(qū)域。(2)上述具有統計學差異腦區(qū)的灰質體積與VAS評分及病程均未見明顯相關性(P0.05)。結論: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

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