论文部分内容阅读
目的 :应用血氧水平依赖性功能性磁共振成像 (BOLD -fMRI)技术 ,探讨直肠气囊扩张刺激下大脑内脏痛觉中枢的兴奋情况 ,并比较肠易激综合征 (IBS)病人在不同容量刺激下兴奋区分布、范围及强度与正常人群的差异性。方法 :直肠气囊扩张 30ml、6 0ml、90ml及 12 0ml时采集受试者 (包括 2 6例IBS病人和 11例健康志愿者 )脑部的fM RI数据。结果 :大多数受试者对直肠气囊扩张刺激能明显激活扣带前皮质 (35 37)、脑岛皮质 (37 37)、额前皮质 (37 37)及丘脑 (35 37)。IBS病人在直肠气囊扩张 12 0ml时脑岛皮质 (IC)、额前皮质 (PFC)、丘脑 (THAL)的兴奋面积和信号变化幅度均较正常对照组显著增高 (P <0 .0 5 )。而且 ,IBS病人在直肠气囊扩张 90ml和 12 0ml时的痛觉评分也显著高于对照组 (P <0 .0 5 )。结论 :fMRI是一种较为直观且准确的观察脑功能活动的脑显像技术 ,可发现部分肠易激综合征病人存在对直肠内气囊扩张刺激引起的内脏感觉过敏。本研究显示国内IBS病人中枢内脑岛皮质、额前皮质可能是参与内脏感觉的主要部位。
OBJECTIVE: To explore the excitability of the visceral central nervous system of the brain under rectal balloon dilatation by using BOLD-fMRI technique and compare the effects of stimulation with irritable bowel syndrome (IBS) Excitement area distribution, scope and intensity and the normal population differences. Methods: The fM RI data were collected from the brains of subjects (including 26 IBS patients and 11 healthy volunteers) at 30 ml, 60 ml, 90 ml and 120 ml of rectal balloon. Results: Most of the subjects could significantly activate the anterior cingulate cortex (35 37), the insula cortex (37 37), the prefrontal cortex (37 37) and the thalamus (35 37). Compared with the normal control group, the excitatory area and signal amplitude of cerebral insular cortex (IC), prefrontal cortex (PFC) and thalamus (THAL) were significantly increased in IBS patients when the rectal balloon was expanded 120 ml (P <0.05). Moreover, the pain scores of IBS patients at the 90 and 120 ml rectal balloon dilation were also significantly higher than those in the control group (P <0.05). Conclusion: fMRI is a more intuitive and accurate observation of brain function of brain imaging technology, we can find some patients with irritable bowel syndrome, there is rectal balloon dilation stimulus visceral hypersensitivity. This study shows that central IBS and prefrontal cortex in IBS patients may be the main part involved in visceral sensation.