作　　者： (谭子虎）; (柳弘汉）; (潘海松）; (宋阳）; (罗远超）;

机构地区： 湖北省中医院老年病科,湖北武汉434000

出　　处： 《中医药临床杂志》 2017年第8期1140-1143,共4页

摘　　要： 目的:探讨血管性痴呆(VD)患者不同中医证型磁共振波谱(1H-MRS)检查特点。方法:对VD肾精亏虚、痰浊阻窍、瘀血阻络患者各15例,行头颅1H-MRS检查,测得N-乙酰天门冬氨酸(NAA)、乙酰胆碱(Cho)、肌酸(Cr)及NAA/Cr、Cho/Cr。结果:其中右侧丘脑中Cho/Cr及NAA/Cr3组比较未见明显差异。左侧丘脑中NAA/Cr肾精亏虚组低于瘀血阻络组(P<0.05);3组Cho/Cr比较未见明显差异。右侧额叶中Cho/Cr痰浊阻窍组高于瘀血阻络组(P<0.05);肾精亏虚证患者NAA/Cr比值明显低于痰浊阻窍组(P<0.01)和瘀血阻络组(P<0.05)。左侧额叶中Cho/Cr痰浊阻窍组高于瘀血阻络组(P<0.05);肾精亏虚证患者NAA/Cr比值明显低于痰浊阻窍组(P<0.05)和瘀血阻络组(P<0.01)。右侧海马Cho/Cr痰浊阻窍组高于其他2组(P<0.01);3组NAA/Cr比较未见明显差异。左侧海马中Cho/Cr及NAA/Cr3组比较未见明显差异。结论:肾精亏虚证、痰浊阻窍证及瘀血阻络证患者的1H-MRS有不同表现。其中,肾精亏虚证患者双侧额叶NAA/Cr水平较其他2组下降,可作为其诊断成立的依据之一。痰浊阻窍证患者双侧额叶及海马Cho/Cr较其瘀血阻络组有不同水平的升高,可作为鉴别诊断。 Objective： To investigate the characteristics of magnetic resonance spectroscopy （1H-MRS） in different TCM syndromes of patients with vascular dementia （VD）. Method： A total of 45 patients with VD were assigned into the kidney essence deficiency group （n=15）, Phlegm turbid blocking upper orifices group （n=15） and Blood stasis obstruct- ing brain collaterals group （n=lS） . Every volunteers were detected by MRS.And the 1H-MRS value： Nacetylaspartate （NAA）, Choline （Cho）, Creatine （Cr） and NAA/Cr, Cho/Cr were measured.Result： There were no significant differences in Cho/Cr and NAA/Cr in right thalamus.In right thalamus, The value of NAA/Cr in the kidney essence deficiency group were significantly lower than Blood stasis obstructing brain collaterals group （P〈0.05）, There was no significant differ- ence in Cho/Cr between the three groups.In bilateral frontal lobe, the value of NAA/Cr in the kidney essence deficiency group were significantly lower than Phlegm turbid blocking upper orifices group and Blood stasis obstructing brain collaterals group IP〈0.05-0.01）, The value of Cho/Cr in the Phlegm turbid blocking upper orifices group significantly higher than Blood stasis obstructing brain collaterals group （P〈0.05）. In right hippocampus, the value of Cho/Cr in the Phlegm turbid blocking upper orifices group significantly higher than the other two groups （P〈0.01）, There were no significant differences in NAA/Cr. Cho/Cr and NAA/Cr in left hippocampus had no significant difference.Conclusion：There were different manifestations with 1H-MRS in three group volunteers. The level of NAA/Cr in bilateral frontal lobe of patients with deficiency of kidney essence deficiency group is lower than that of the other two groups, which can be used as one of the bases of its diagnosis. Cho/Cr in bilateral frontal lobe and hippocampus of patients with Phlegm turbid blocking upper orifices group was higher than that of Blood stasis obstructing brain collaterals group, which co

关 键 词： 血管性痴呆 中医证型 磁共振波谱