论文部分内容阅读
目的:初步探讨胃食管反流病(GERD)相关非心源性胸痛(NCCP)患者大脑功能区激活的特点,了解内脏高敏感在其发病中的作用。方法:4名正常对照及8名诊断为GRED相关NCCP患者,行食管内酸灌注,灌注前、中、后行功能性磁共振扫描,寻找与食管内刺激相关的脑功能区。结果:(1)静息状态下,正常对照组及GERD相关NCCP组中均观察到部分脑区活跃。(2)在食管内酸刺激时,正常对照组及GERD相关NCCP组患者较静息态时均存在PFC、ACC、IC及丘脑区的明显激活。(3)对两组激活的各脑区进行分析,采用中位数(范围)法,结果发现GERD相关NCCP组丘脑区激活较明显,但两组受试者在上述四个区域激活上无显著统计学差异(P>0.05)。(4)在GERD相关NCCP亚组中,NERD+组PFC区BA10激活较明显,NERD-SI-组IC激活较明显。结论:PFC、ACC、IC及丘脑可能是调节GERD相关NCCP患者食管内脏感知的重要脑功能区;GERD相关NCCP患者各亚组可能通过不同的高级皮层调节内脏感觉。
Objective: To investigate the characteristics of brain activation in patients with gastroesophageal reflux disease (GCPD) associated with non-cardiac chest pain (NCCP) and to understand the role of visceral hypersensitivity in its pathogenesis. Methods: Four normal controls and eight NCCP patients diagnosed as GRED were enrolled in this study. Functional esophageal perfusion, perfusion, middle and posterior functional magnetic resonance (MR) scanning were performed in esophageal squamous cell carcinoma in search of brain functional areas associated with esophageal stimulation. Results: (1) In resting state, some brain regions were observed in both normal control group and GERD-associated NCCP group. (2) In the esophageal acid stimulation, PFC, ACC, IC and thalamic regions were significantly activated in both normal control group and GERD-associated NCCP group at resting state. (3) The activation of brain regions of the two groups were analyzed using the median (range) method, found that GERD-related NCCP group more obvious activation of the thalamus, but the two groups of subjects in the activation of these four regions was not significant Statistical difference (P> 0.05). (4) In GERD-related NCCP subgroup, BA10 activation in PFC area of NERD + group was more obvious, and IC activation in NERD-SI- group was more obvious. Conclusions: PFC, ACC, IC and thalamus may be GERD-related NCCP patients regulate important brain areas esophageal visceral perception; GERD-related NCCP patient subgroups may regulate visceral sensation by different advanced cortex.