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目的应用磁共振波谱技术(MRS)探讨热射病(HS)患者小脑的代谢物变化。方法研究对象来源于2013年8月滨州医学院烟台附属医院重症医学科收治的8例HS患者和同期7名年龄相匹配的健康志愿者(对照组),采用化学位移成像采集MRS数据,测量HS患者及正常对照组小脑的代谢物比值NAA/Cr、NAA/Cr2、Cho/Cr、Cho/Cr2、NAA/Cho,采用Mann-Whitney U检验比较两组间MRS代谢参数之间的差异,HS患者小脑的代谢物比值并与Glasgow昏迷评分法(GCS)进行Pearson相关性分析。结果 HS患者小脑的NAA/Cr显著低于对照组(0.79±0.10 vs 1.03±0.11,P=0.004),Cho/Cr低于对照组(0.85±0.13 vs 0.99±0.05,P=0.032),NAA/Cr2、Cho/Cr2、NAA/Cho与对照组差异无统计学意义(均P>0.05);HS患者小脑的NAA/Cr与其GCS评分存在显著正相关(r=0.748,P=0.033)。结论应用MRS技术可敏感地探测HS患者小脑的代谢物异常,并可通过小脑的代谢物比值NAA/Cr判断病情的轻重。
Objective To investigate the changes of cerebellum metabolites in patients with fever (HS) by magnetic resonance spectroscopy (MRS). Methods The subjects were from 8 HS patients admitted to the Department of Critical Care Medicine of Yantai Affiliated Hospital of Binzhou Medical College in August 2013 and 7 matched healthy volunteers (control group) in the same period. MRS data were collected by chemical shift imaging, NAA / Cr2, Cho / Cr, Cho / Cr2 and NAA / Cho were compared between the two groups using the Mann-Whitney U test. The differences in metabolic parameters of MRS between the two groups were compared. Cerebellum metabolites ratio and Pearson correlation analysis with Glasgow Coma Scale (GCS). Results NAA / Cr in the cerebellum of HS patients was significantly lower than that of control group (0.79 ± 0.10 vs 1.03 ± 0.11, P = 0.004), Cho / Cr was lower than that of control group (0.85 ± 0.13 vs 0.99 ± 0.05, P = 0.032) There were no significant differences in Cr2, Cho / Cr2, NAA / Cho and control group (all P> 0.05). There was a significant positive correlation between cerebellar NAA / Cr and GCS score in HS patients (r = 0.748, P = 0.033). Conclusions The MRS technique can detect the abnormalities of cerebellum in patients with HS, and the severity of the disease can be judged by the ratio of metabolites of cerebellum NAA / Cr.