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目的:探讨~1H-MRS在ALS患者的临床应用价值。方法:对34例ALS病人双侧大脑中央前回进行质子波谱分析,同时进行临床量表评分,并随访其中进行治疗的24例病例。治疗组分两组:力如太组(力如太50 mg bid)和免疫治疗组(环磷酰胺和地塞米松)。结果:①NAA/Cr比值在ALS病人上显著降低,P<0.01;②力如太治疗最初的1个月,NAA/Cr比值上升,P<0.05,而免疫治疗组(环磷酰胺+地塞米松)无此变化;③NAA/Cr的改善与力如太组在Appel延髓评分的改善相一致,且NAA/Cr比值更为敏感。结论:~1H-MRS中的NAA/Cr比值可以作为大脑中央前回运动神经元受损的指标,并且也可用来客观地监测疾病的进展,观察药效。
Objective: To investigate the clinical value of ~ 1H-MRS in patients with ALS. Methods: Proton spectroscopic analysis was performed on the bilateral frontal gyrus of both sides of the brain in ALS patients. At the same time, clinical scores were scored and 24 cases were treated. Therapeutic components were divided into two groups: Li Ru Tai (50 mg twice daily) and immunotherapy (cyclophosphamide and dexamethasone). Results: ① The NAA / Cr ratio decreased significantly in patients with ALS, P <0.01; ② The ratio of NAA / Cr increased in the first month after treatment with streptozotocin (P <0.05) ) Did not change. (3) The improvement of NAA / Cr was consistent with the improvement of appellation of appendix medulla in Li-Tai group, and the NAA / Cr ratio was more sensitive. CONCLUSION: The NAA / Cr ratio in ~ 1H-MRS can be used as an index of motor neurons in the front of the brain. It can also be used to objectively monitor the progress of the disease and to observe the efficacy.