2型糖尿病患者听皮层区磁共振氢质子波谱分析

~1H-Magnetic Resonance Spectroscopy Study of Auditory Cortex Metabolism in Patients with Type 2 Diabetes

宋冬梅;徐英霞;刘涛;吕欣;王宝山;

1:河北医科大学第一医院耳鼻咽喉头颈外科

2:河北省石家庄市正定县人民医院

摘要
目的探讨磁共振氢质子波谱(1 H magnetic resonance spectroscopy,1 H-MRS)技术对2型糖尿病患者听皮层神经细胞损伤的早期预警作用。方法随机抽取确诊的糖尿病患者98例,根据纯音听阈将其分为糖尿病并双侧耳聋组(32例)、糖尿病并单侧耳聋组(18例)、单纯糖尿病组(48例),以健康志愿者15例为正常对照组,各组行双侧颞横回听皮层1 H-MRS检测,根据神经代谢产物其峰下面积计算N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、肌醇/肌酸(mI/Cr)、N-乙酰天门冬氨酸/胆碱(NAA/Cho)值,比较各组间上述各项指标的差异;对血糖值与各神经代谢产物的相关性进行Pearson相关分析,根据ROC曲线面积判定上述各指标诊断早期糖尿病并感音神经性听力损失的灵敏度及特异度。结果糖尿病患者空腹血糖值与NAA/Cr、NAA/Cho呈负相关(P<0.05),与Cho/Cr、mI/Cr呈正相关(P<0.05);与正常对照组相比,单纯糖尿病组听皮层神经代谢产物NAA/Cho、NAA/Cr降低(P<0.05),Cho/Cr、mI/Cr升高;糖尿病合并双侧耳聋组NAA/Cho降低(P<0.05),Cho/Cr升高;糖尿病合并单侧耳聋组患侧和健侧NAA/Cho均下降,且患侧NAA/Cho较健侧降低(P<0.05)。NAA/Cho的ROC曲线下面积为81%,准确性较高,且当NAA/Cho为1.65时可以作为单纯糖尿病与糖尿病合并感音神经性聋的分界指标,其余神经代谢产物ROC曲线下面积均<50%。结论听皮层磁共振氢质子波谱分析指标NAA/Cho有可能作为判定糖尿病人群发生感音神经性聋的早期听皮层代谢预警指标。
关键词
2型糖尿病;听皮层;神经代谢产物;磁共振氢质子波谱
基金项目(Foundation):
河北省高等学校科学技术研究重点项目(ZH2011220);; 河北省科学技术研究与发展计划项目(12276103D)联合资助
作者
宋冬梅;徐英霞;刘涛;吕欣;王宝山;
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