重度OSAS患者前额叶皮质及岛叶1H—MR波谱研究

目的：利用氢质子MRS（IH-MRS）探讨重度阻塞性呼吸睡眠暂停综合症（Severeobstructivesleepapneasyndrome，S-OSAS）患者前额叶皮质及岛叶脑代谢产物特征。方法：选择18例S-OSAS患者（S-OSAS组）和15名健康志愿者（HC组）行左侧前额叶皮质及岛叶1H-MRS检查，测量两组左侧前额叶皮质区及岛叶N-乙酰天冬氨酸／肌酸（NAA／Cr）、胆碱／肌酸（Cho／Cr）值。对患S-OSAS累计时间与前额叶皮质及岛叶NAA／Cr作直线相关分析。结果：与正常对照组相比，S-OSAS患者左侧前额叶皮质、岛叶NAA／Cr比值降低，分别为1．43±0．47、1．34±0．06，对照组分别为1．51±0．65、1．45±0．07；S-OSAS组患者左侧前额叶皮质、岛叶Cho／Cr分别为0．90±0．08、1．195：0．13，对照组分别为0．87±0．07、1．09±0．02，两组差异有统计学意义。前额叶皮质及岛叶代谢物NAA／Cr与患S-OSAS累计时间成负相关性（r值分别为-0．965、-0．955，P〈0．01）。结论：1H-MRS显示S-OSAS患者前额叶皮质及岛叶病理生理变化，从该区代谢物的改变反应出S-OSAS患者执行及情感功能的异常，其NAA/Cr改变程度与患S-OSAS累计时间相关。

A Study of 1H-MR Spectroscopy in the Prefrontal Cortex and Insula of Patients with Severe OSAS

Objective： To explore the characteristics of proton magnetic resonance spectroscopy（1H-MRS） in the prefrontal cortex and insula ofpatiens with severe obstructive sleep apnea syndrome（S-OSAS）. Methods： 18 patients with S-OSAS and 15 healthy controls （HC）were studied using 1H-MRS to detect the changes of left prefrontal cortex and insula.he ratio of N-acetylaspartate/creatine（NAA/Cr） and choline/creatine （Cho/Cr） was respectively measured in the left prefrontal cortex and insula. Results： As compared with healthy vol- unteers, the patients with severe OSAS had a significant lower ratio of NAA/Cr in the left prefrontal cortex （1.43± 0.47 vs 1.51±0.65, P〈0.05）, left insula （1.34± 0.06 vs 1.45± 0.07, P〈0.05）, while the patients with severe OSAS patients had a significant increased ratio of Cho/Cr in the left prefrontal cortex （0.90± 0.08 vs 0.87± 0.07, P〈0.05）, left insula（1.19± 0.13 vs 1.09± 0.02, P〈0.05）. There was a neg- ative linear correlation between the total eummulative time suffering from S-OSAS and the ratio of NAA/Cr in the left prefrontal cortex, insulation. Conclusions： The data from 1H-MRS study indicate that pathoPhysiological changes may occur in the prefrontal cortex and insula, which suggests the abnormalities of executive function and emotion in patients with S-OSAS. A relationship exits between the S-OSAS metabolic abnormality and total cumulative time suffering from OSAS.