本文選題：型糖尿病 + 聽(tīng)皮層　； 參考：《聽(tīng)力學(xué)及言語(yǔ)疾病雜志》2015年02期

【摘要】：目的探討磁共振氫質(zhì)子波譜(1 H magnetic resonance spectroscopy,1 H-MRS)技術(shù)對(duì)2型糖尿病患者聽(tīng)皮層神經(jīng)細(xì)胞損傷的早期預(yù)警作用。方法隨機(jī)抽取確診的糖尿病患者98例,根據(jù)純音聽(tīng)閾將其分為糖尿病并雙側(cè)耳聾組(32例)、糖尿病并單側(cè)耳聾組(18例)、單純糖尿病組(48例),以健康志愿者15例為正常對(duì)照組,各組行雙側(cè)顳橫回聽(tīng)皮層1 H-MRS檢測(cè),根據(jù)神經(jīng)代謝產(chǎn)物其峰下面積計(jì)算N-乙酰天門(mén)冬氨酸/肌酸(NAA/Cr)、膽堿/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)、N-乙酰天門(mén)冬氨酸/膽堿(NAA/Cho)值,比較各組間上述各項(xiàng)指標(biāo)的差異;對(duì)血糖值與各神經(jīng)代謝產(chǎn)物的相關(guān)性進(jìn)行Pearson相關(guān)分析,根據(jù)ROC曲線(xiàn)面積判定上述各指標(biāo)診斷早期糖尿病并感音神經(jīng)性聽(tīng)力損失的靈敏度及特異度。結(jié)果糖尿病患者空腹血糖值與NAA/Cr、NAA/Cho呈負(fù)相關(guān)(P0.05),與Cho/Cr、mI/Cr呈正相關(guān)(P0.05);與正常對(duì)照組相比,單純糖尿病組聽(tīng)皮層神經(jīng)代謝產(chǎn)物NAA/Cho、NAA/Cr降低(P0.05),Cho/Cr、mI/Cr升高;糖尿病合并雙側(cè)耳聾組NAA/Cho降低(P0.05),Cho/Cr升高;糖尿病合并單側(cè)耳聾組患側(cè)和健側(cè)NAA/Cho均下降,且患側(cè)NAA/Cho較健側(cè)降低(P0.05)。NAA/Cho的ROC曲線(xiàn)下面積為81%,準(zhǔn)確性較高,且當(dāng)NAA/Cho為1.65時(shí)可以作為單純糖尿病與糖尿病合并感音神經(jīng)性聾的分界指標(biāo),其余神經(jīng)代謝產(chǎn)物ROC曲線(xiàn)下面積均50%。結(jié)論聽(tīng)皮層磁共振氫質(zhì)子波譜分析指標(biāo)NAA/Cho有可能作為判定糖尿病人群發(fā)生感音神經(jīng)性聾的早期聽(tīng)皮層代謝預(yù)警指標(biāo)。
[Abstract]:Objective to investigate the early warning effect of 1H magnetic resonance spectroscopy1 H-MRS technique on nerve cell injury in auditory cortex of type 2 diabetic patients.Methods Ninety-eight patients with diabetes mellitus were randomly selected and divided into three groups according to pure tone hearing threshold: 32 patients with diabetes mellitus with bilateral deafness, 18 patients with diabetes mellitus with unilateral deafness, 48 patients with diabetes mellitus, and 15 healthy volunteers as control group.The correlation between blood glucose and neurometabolites was analyzed by Pearson.According to the area of ROC curve, the sensitivity and specificity of the above indexes in the diagnosis of early diabetes mellitus and sensorineural hearing loss were determined.In diabetic patients with unilateral deafness, both the NAA/Cho of the affected side and the healthy side were decreased, and the area under the ROC curve of the NAA/Cho in the affected side was lower than that in the healthy side, and the area under the ROC curve was 81. The accuracy was higher than that in the normal side.When NAA/Cho was 1. 65, it could be used as a dividing line between diabetes mellitus and diabetic patients with sensorineural deafness. The area under the ROC curve of other nerve metabolites was 50.Conclusion NAA/Cho may be used as an early warning index of auditory cortex metabolism in diabetic patients with sensorineural deafness.
【作者單位】： 河北醫(yī)科大學(xué)第一醫(yī)院耳鼻咽喉頭頸外科;河北省石家莊市正定縣人民醫(yī)院;
【基金】：河北省高等學(xué)�？茖W(xué)技術(shù)研究重點(diǎn)項(xiàng)目(ZH2011220) 河北省科學(xué)技術(shù)研究與發(fā)展計(jì)劃項(xiàng)目(12276103D)聯(lián)合資助
【分類(lèi)號(hào)】：R587.1;R764

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