氢质子波谱在阿尔茨海默病中的价值

目的探讨质子磁共振波谱（ZH—MRS）在阿尔茨海默病（AD）中的诊断价值。方法采用刺激激励回波采样方式对29例AD患者和20例老年健康者的海马、颞顶叶和扣带回行MRS检查；分析的代谢产物有N－乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、肌醇（mI），并比较分析其相互间比值在两组间的差异结果AD患者在海马、颞顶叶和扣带回的NAA分别为（0．40±0．06）、（0．42±0．06）、（0．43±0．08），与健康组比较差异无显著性（P〉0．05）;mI分别为（0．25±0．08）、（0．23±0．06）、（0．21±0．05），与健康组比较差异有显著性（R0．05）NAA／Cr分别为（1．30±0．10）、（1．40±0．11）、（1．42±0．12），与健康组比较差异无显著性（P〉0．05）;mI／Cr分别为（0．81±0，07）、（0．78±0．08）、（0．70±0．06），与健康组比较差异有显著性（P〈0．05kmI／NAA分别为（0．61±0．06）、（0．55±0．08）、（0．49±O．07），与健康组比较差异有显著性（P〈O．05）。AD患者NAA、NAA／Cr的下降和mI、mI／Cr、mI／NAA的上升，海马〉颞顶叶〉扣带回。结论AD患者MRS改变，主要体现在NAA的下降和mI的上升，对AD的诊断有一定的参考作用。

Diagnosis value of proton magnetic resonance spectroscopy in alzheimer disease

Objective To study the diagnosis value of proton magnetic resonance spectroscopy(1H-MRS)in Alzheimer disease(AD).Methods Using stimulated echo acquisition mode,29 AD patients and 20 elderlv healthy ones as control group were underwent with Magnetic ResonaJlce Spectrum (MRs)examination in hippocampus,temporal parietal cortex and cingulate gyrus,the metabolites of MRS were analvzed to have N-aeetyl aspartate(NAA),creatine(Cr),choline(Cho),myo-inositol (mI),and comDarle the ratio of each other as well as the difference between the two groups.Rmulta NAA of AD patients in hippocampus,temporal parietal cortex and ringulate gyrus were(0.40±0.06),(0.42±0.06),(0.43±0.08),respectively, and have no significant difference to the healthy group(P＞0.05);mI were(0.25±0.08).(0.23±0.06),(0.21±0.05),respectively,and have significant difference to the healthy group(P＜0.05):NAA/Cr werle(1.30±O.10),(1.40±0.11),(1.42±0.12),respectively,and have no significant differenoe to the healthy group(P＞0.05);mI/Cr were,(0.81±0.07),(0.78±0..08),(0.70±0.06),respectively,and have significant difference to the healthy group(P＜0.05);mI,NAA were(0.61±0.06),(0.55±0.08),(0.49±0.07),respeetively,and have significant difference to the healthy group(P＜0.05).In AD patients,NAA,NAA/Cr decrease and mI,mI/Cr,mI/NAA increase,and the value in hippocampus＞temporal parietal cortex＞cingulate gyrus.Conclusion The changes of MRS in AD patients,mainly reflected a decline in NAA and rise in mI,which has some reference in the diagnosis in AD.