摘要
目的利用磁共振波谱分析(MRS)评价肝硬化患者脑代谢物的异常变化及其与Child-Pugh分级和肝功能指标的相关性。方法应用3.0T磁共振对52例乙型肝炎肝硬化患者(Child A级20例、Child B级14例、Child C级18例)及15例慢性乙型肝炎患者进行磁共振波谱分析,计算脑代谢物Cho(胆碱)、m(I肌醇)、NAA(N-乙酰天门冬氨酸)、C(r肌酸)和GLX(6谷氨酰胺复合物)峰下面积、脑代谢物峰下面积与Cr比值(NAA/Cr、Cho/Cr、ml/Cr、Glx6/ml)。结果Child-Pugh A级患者与对照组mI、GLX6比较,差异有统计学意义,Child-Pugh B级与Child-Pugh A级Cho、mI、GLX6比较,差异有统计学意义(P<0.01),Child-PughC级与Child-Pugh B级Cho、mI比较,差异有统计学意义(P<0.01或P<0.05);Child-Pugh A级与对照组ml/Cr、Glx6/Cr比较,差异有统计学意义(P<0.01),Child-Pugh B级与Child-Pugh A级Cho/Cr、ml/Cr、Glx6/Cr比较,差异有统计学意义(P<0.01或P<0.05),Child-Pugh C级与Child-Pugh B级Cho/Cr、ml/Cr比较,差异有统计学意义(P<0.05);肝性脑病与无肝性脑病患者脑代谢物峰下面积比值(Cho/Cr、ml/Cr、Glx6/Cr)比较,差异有统计学意义(P<0.01);Child-Pugh分级与Glx6/Cr呈正相关,与Cho/Cr、ml/Cr呈负相关;肝硬化患者TBIL、PT与Cho/Cr、ml/Cr呈负相关,与Glx6/Cr呈正相关。ALB与Cho/Cr、ml/Cr呈正相关,与Glx6/Cr呈负相关。ALT与NAA/Cr、Cho/Cr、ml/Cr、Glx6/Cr无明显相关性。结论肝硬化及肝性脑病患者存在脑代谢物浓度异常改变,它可作为肝硬化和肝性脑病早期诊断及程度评价的一项指标。
Objectives To evaluate cerebral metabolite changes in patients with cirrhosis by using MR chemical shift imaging （MRS）. Methods 52 patients with liver cirrhosis （20 with Child-Pugh A,14 with Child-Pugh B,and 18 with Child-Pugh C） and 15 patients with chronic hepatitis B were analysed by 3.0T MRS. The areas under peak of cerebral metabolites （Cho,mI,.NAA,Cr,GLX6）,and the ratio of the areas under peak of cerebral metabolites and Cr（NAA/ Cr,Cho/Cr,ml/Cr,lx6/ml）were calculated. Results The areas of mI and GLX6 between Child-Pugh A group and control group showed statistical difference （P〈0.01）. The areas of Cho,mI,GLX6 among Child-Pugh A group,Child-Pugh B group and Child-Pugh C group showed statistical difference（P〈0.01 or P〈0.05 ）;It had statistical significance（P〈0.01 ）for Cho/Cr, mI/Cr,GLX6/Cr among control group,Child-Pugh A group,Child-Pugh B group and Child-Pugh C （P〈0.01 or P〈0.05）. The ratio of the areas under peak of cerebral metabolites and Cr （NAA/Cr,Cho/Cr,ml/Cr,lx6/ml）between HE group and without HE group showed statistical difference （P〈0.01）. Child-Pugh grading was positively correlated with Glx6/Cr,and negatively correlated with Cho/Cr,ml/Cr. TBIL,PT were negatively correlated with Cho/Cr,ml/Cr,and positively correlated with Glx6/Cr. ALB was positively correlated with Cho/Cr,ml/Cr,and negatively correlated with Glx6/Cr. Conclusion There are cerebral metabolic changes in patients with cirrhosis and HE.
出处
《实用肝脏病杂志》
CAS
2009年第2期114-117,共4页
Journal of Practical Hepatology
