2型糖尿病患者尿微量白蛋白与脑组织代谢物变化的关系

doi:10.6040/j.issn.1671-7554.0.2014.543

摘要/Abstract

摘要： 目的采用氢质子磁共振波谱(¹H-MRS)技术检测2型糖尿病(T2DM)患者脑内基底节、半卵圆中心区域脑组织代谢改变,表明尿微量白蛋白是脑组织损害的早期标志.方法初诊T2DM患者61例,根据尿微量白蛋白排泄率(UAER)分为正常微量白蛋白尿组(DM组,UAER<20 μg/min,n=29)和微量白蛋白尿组(DA组,20 μg/min≤UAER<200 μg/min,n=32), 同时选取20名健康志愿者为正常对照组(HC组).所有受试者行常规磁共振(MRI)以及¹H-MRS检查.结果基底节区:DA组NAA/Cr比值较DM组、HC组明显降低(P<0.05),DM组NAA/Cr比值较HC组明显降低(P<0.05),DA组Cho/Cr比值较HC组明显升高(P<0.05).半卵圆中心区:DA组NAA/Cr比值明显低于HC组(P<0.05),DM组Cho/Cr比值较HC组明显升高(P<0.05),DA组MI/Cr比值较DM组、HC组明显升高(P<0.05).DA组基底节区NAA/Cr值与UAER水平呈负相关性(r=-0.768, P<0.05).结论尿微量白蛋白升高的T2DM患者可更容易合并脑组织损伤.

关键词: 微量白蛋白尿, 半卵圆中心, 2型糖尿病, 基底节, 氢质子磁共振波谱

Abstract: Objective To investigate the cerebral metabolic changes in basal ganglia and semi oval center using proton magnetic resonance spectroscopy(¹H-MRS) in order to prove that microalbuminuria is an early marker of brain tissue damage in patients with type 2 diabetes mellitus (T2DM). Methods With reference to the urinary albumin excretion ratio (UAER), 61 patients with newly diagnosed T2DM were divided into the normal microalbuminuria group (DM group, UAER<20 μg/minute, n=29) and microalbuminuria group (DA group, 20 μg/min≤UAER<200 μg /min, n=32). Meanwhile, 20 healthy controls (HC group) were enrolled. Conventional magnetic resonance imaging (MRI) and ¹H-MRS were performed on all participants. Results In the basal ganglia area, NAA/Cr ratio of the DA group was significantly lower than that of the DM and HC group; NAA/Cr ratio of the DM group was markedly lower than that of the HC group; Cho/Cr ratio was remarkably increased in the DA group compared with the HC group (P<0.05). In the semi oval center area, NAA/Cr ratio of the DA group was significantly lower than that of the HC group; MI/Cr ratio was notedly higher in the DA group compared with the DM and HC group (P<0.05). NAA/Cr ratio of the DA group in the basal ganglia was negatively correlated with the level of UAER (r=-0.768, P<0.05). Conclusion T2DM patients with elevated microalbuminuria are more prone to brain tissue damage.

Key words: Proton magnetic resonance spectroscopy, Semi oval center, Microalbuminuria, Basal ganglia, Type 2 diabetes mellitus

中图分类号:

R578.2

胡芳志, 张正军, 耿厚法, 梁秋华, 孙琳. 2型糖尿病患者尿微量白蛋白与脑组织代谢物变化的关系[J]. 山东大学学报（医学版）, 2015, 53(2): 43-47.

HU Fangzhi, ZHANG Zhengjun, GENG Houfa, LIANG Qiuhua, SUN Lin. Relationship between microalbuminuria and brain damage in patients with type 2 diabetes mellitus[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(2): 43-47.

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