【摘要】：功能性胃腸病是指出現(xiàn)了腹脹、腹痛、腹瀉和便秘等消化系統(tǒng)癥狀但又沒(méi)有生化或結(jié)構(gòu)異常的一組疾病。在世界范圍內(nèi)都有著很高的發(fā)病率，基于歐美人口的調(diào)查顯示，歐美人群中功能性胃腸病的患病率為21%-41%，在我國(guó)也有10%-12%的社區(qū)人口患有功能性胃腸病。隨著對(duì)功能性胃腸病研究的深入，人們發(fā)現(xiàn)腦腸軸互動(dòng)的異常對(duì)功能性胃腸病的發(fā)生及發(fā)展起到了非常重要的作用。 作為功能性胃腸病的主要分支之一，功能性消化不良在功能性胃腸病的臨床診斷中占有非常大的比例。通過(guò)正離子斷層掃描技術(shù)，研究人員發(fā)現(xiàn)功能性消化不良患者靜息態(tài)的大腦活動(dòng)以及中樞神經(jīng)系統(tǒng)的胃腸刺激加工方面存在異常。另外研究人員通過(guò)使用功能磁共振成像技術(shù)同樣發(fā)現(xiàn)功能性消化不良患者靜息態(tài)的大腦活動(dòng)以及一些腦區(qū)之間的功能連接存在異常。此外，有研究表明，人類(lèi)的大腦是由一系列空間獨(dú)立但功能相關(guān)的靜息態(tài)功能網(wǎng)絡(luò)組成，這些功能網(wǎng)絡(luò)協(xié)同完成人類(lèi)的正常行為。然而關(guān)于功能性消化不良患者靜息態(tài)功能網(wǎng)絡(luò)的研究還很少，因此，本研究主要結(jié)合核磁共振成像技術(shù)、獨(dú)立成分分析以及格蘭杰因果分析方法對(duì)靜息態(tài)功能網(wǎng)絡(luò)進(jìn)行初步的研究，研究的主要結(jié)果和創(chuàng)新點(diǎn)如下： 1，功能性消化不良患者大腦顯著網(wǎng)絡(luò)相關(guān)的因果連接模式出現(xiàn)異常。 本研究通過(guò)獨(dú)立成分分析以及條件格蘭杰因果分析對(duì)功能性消化不良患者大腦顯著網(wǎng)絡(luò)相關(guān)的靜息態(tài)功能網(wǎng)絡(luò)的因果連接模式進(jìn)行研究。我們發(fā)現(xiàn)功能性消化不良患者大腦的顯著網(wǎng)絡(luò)對(duì)默認(rèn)網(wǎng)絡(luò)以及中心執(zhí)行網(wǎng)絡(luò)的因果調(diào)節(jié)作用減弱。并且腦島對(duì)于默認(rèn)網(wǎng)絡(luò)以及中心執(zhí)行網(wǎng)絡(luò)的因果調(diào)節(jié)作用被前扣帶替代。該研究表明功能性消化不良患者大腦靜息態(tài)功能網(wǎng)絡(luò)之間的調(diào)節(jié)作用異常是腦島以及前扣帶回皮層的異常導(dǎo)致的。 2，功能性消化不良患者大腦默認(rèn)網(wǎng)絡(luò)存在異常。 本研究通過(guò)獨(dú)立成分分析以及雙樣本t檢驗(yàn)對(duì)功能性消化不良患者大腦的默認(rèn)網(wǎng)絡(luò)進(jìn)行研究。發(fā)現(xiàn)患者的前扣帶回皮層、腹內(nèi)側(cè)前額葉皮層、背外側(cè)前額葉皮層、感覺(jué)運(yùn)動(dòng)皮層、顳極、旁海馬回、下頂葉以及眶額葉皮層的活動(dòng)存在異常。其中旁海馬區(qū)域的活動(dòng)與功能性消化不良患者的病情嚴(yán)重程度呈顯著的反相關(guān)關(guān)系。另外通過(guò)條件格蘭杰因果分析我們發(fā)現(xiàn)功能性消化不良患者的旁海馬區(qū)域明顯孤立，，并且前扣帶與這些異常區(qū)域之間的有效連接減弱。本研究首次對(duì)功能性消化不良患者的默認(rèn)網(wǎng)絡(luò)進(jìn)行研究，并為功能性消化不良患者中樞神經(jīng)異常提供影像學(xué)證據(jù)。
[Abstract]:Functional gastrointestinal disease refers to a group of diseases with abdominal distension, abdominal pain, diarrhea, constipation and other digestive system symptoms without biochemical or structural abnormalities. There is a high incidence rate in the world. Based on the survey of European and American population, the prevalence rate of functional gastrointestinal disease in European and American population is 21% -41%. In our country, 10% -12% of the community population also have functional gastrointestinal disease. With the development of functional gastrointestinal disease, it has been found that abnormal interaction between brain and intestinal axis plays an important role in the occurrence and development of functional gastrointestinal disease. As one of the main branches of functional gastrointestinal disease, functional dyspepsia occupies a large proportion in the clinical diagnosis of functional gastrointestinal disease. Using positive ion tomography, the researchers found abnormalities in resting brain activity in patients with functional dyspepsia and in the processing of gastrointestinal stimuli in the central nervous system. In addition, functional magnetic resonance imaging (fMRI) techniques were also used to detect resting brain activity and functional connections in some brain regions in patients with functional dyspepsia. In addition, studies have shown that the human brain is composed of a series of spatially independent but functionally related resting functional networks, which cooperate to accomplish normal human behavior. However, there is little research on resting functional network in patients with functional dyspepsia. Independent component Analysis (ICA) and Granger causality Analysis (Granger causality Analysis) are used to study the resting functional network. The main findings and innovations are as follows: 1. The causal connection patterns associated with significant network in functional dyspepsia patients are abnormal. In this study, independent component analysis and conditional Granger causality analysis were used to study the causal connection patterns of resting functional networks associated with significant brain network in patients with functional dyspepsia. We found that the significant network of the brain in patients with functional dyspepsia weakens the causal regulation of the default and central executive networks. And the causal adjustment of the island to the default network and the central executive network is replaced by the anterior cingulate band. This study shows that the abnormal regulation between resting functional networks in patients with functional dyspepsia is due to the abnormalities of the cerebral islets and the cortex of anterior cingulate gyrus. 2. The default network of brain in patients with functional dyspepsia is abnormal. The default network of the brain in patients with functional dyspepsia was studied by independent component analysis and two-sample t-test. Abnormal activities were found in the anterior cingulate cortex ventromedial prefrontal cortex dorsolateral prefrontal cortex sensory motor cortex temporal pole paracarpal gyrus inferior parietal lobe and orbital frontal cortex. The activity of parahippocampal region was inversely correlated with the severity of the disease in patients with functional dyspepsia. In addition, by conditional Granger causality analysis, we found that the parahippocampal region in patients with functional dyspepsia was significantly isolated, and the effective connection between the anterior cingulate band and these abnormal regions was weakened. In this study, the default network of patients with functional dyspepsia was studied for the first time, and the imaging evidence was provided for the abnormality of central nervous system in patients with functional dyspepsia.
【學(xué)位授予單位】：西安電子科技大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R57

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