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目的利用单体素MRS探讨无认知功能障碍症状HIV感染者与正常志愿者间不同脑区N-乙酰天冬氨酸(NAA)、胆碱(Cho)及肌酸(Cr)代谢物质的差异。方法采用3.0 T MR扫描仪对CD4细胞计数≥200 cells/μL(22例,A组)、<200 cells/μL(27例,B组)无认知功能障碍的HIV阳性患者及正常志愿者33名(C组)行单体素MRS检查,分别测量基底节区、额叶白质、顶叶白质区域,比较NAA/Cr与Cho/Cr组间差异。结果 A组、B组与C组比较在基底节区NAA/Cr差异具有统计学意义[P=0.011(A组与C组)和P<0.001(B组与C组)]。在额叶白质A组与B组、C组比较NAA/Cr值升高[P=0.002(A组与B组)和P=0.017(A组与C组)]。A组与C组比较Cho/Cr在基底节区与额叶白质区域显示升高(P=0.023和<0.001)。结论 MRS能够检测出无认知障碍症状HIV感染者在脑基底节区域及额叶白质区域存在代谢异常。
OBJECTIVE: To explore the differences of NAC, Cho and Cr metabolites in different brain regions between HIV-infected and normal volunteers without cognitive dysfunction using monomeric MRS . Methods A 3.0 T MR scanner was used to detect the number of CD4 cell counts ≥ 200 cells / μL (22 patients in group A) and <200 cells / μL (n = 27 in patients in group B) with HIV-positive patients without cognitive dysfunction and normal volunteers (Group C). The differences of NAA / Cr and Cho / Cr between the groups of basal ganglia, frontal white matter and parietal white matter were measured respectively. Results The difference of NAA / Cr in basal ganglia was statistically significant between group A, group B and group C (P = 0.011 for group A and C) and P <0.001 for group B and C]. NAA / Cr increased in group A compared with group B and group C [P = 0.002 (group A vs group B) and P = 0.017 (group A vs group C)]. Cho / Cr increased in basal ganglia and frontal white matter regions in group A compared with group C (P = 0.023 and <0.001). Conclusion MRS can detect the presence of metabolic abnormalities in brain basal ganglia and frontal white matter of HIV-infected persons without cognitive impairment.