【摘要】 目的 探讨2型糖尿病(T2DM)患者大脑后扣带回谷氨酸代谢变化及其与血糖的关系，以了解糖尿病脑病病理生理变化的物质基础。方法 连续收集15例T2DM患者和10例健康志愿者，采用TEaveraged PRESS序列行MRS检查，比较2组间大脑后扣带回谷氨酸(Glu)、N乙酰天门冬氨酸(NAA)、乙酰胆碱(Cho)和肌酸(Cr)水平差异，分析代谢物与血糖水平之间的关系。结果 与对照组相比，T2DM组大脑后扣带回Cho (P=0.02)及Glu (P<0.01)含量显著升高，NAA含量显著降低(P=0.03),而Cr在2组间无显著差异(P>0.05)。在对照组和T2DM组，糖化血红蛋白(HbA1c)与Glu之间呈显著正相关(r=0.692,P=0.000),而糖化血红蛋白与NAA呈显著的负相关(r=-0.628,P=0.001)。结论 采用TEaveraged PRESS序列可测定T2DM患者大脑后扣带回脑区代谢物水平的变化，尤其是可以独立测量Glu含量，并发现Glu升高和NAA下降与高血糖有关。更多还原

【Abstract】 Objective To explore the glutamate level change and its correlation with blood glucose in the posterior cingulate of T2DM patients in comparison to healthy controls, using TE-averaged PRESS sequence of in-vivo magnetic resonance spectroscopy to get an insight into the pathophysiology of cerebral damages caused by diabetes.Methods Fifteen patients with T2DM and ten healthy subjects were enrolled. Single voxel proton magnetic resonance spectroscopy(~1H-MRS) was performed on the posterior cingulate, using TE-averaged PRESS sequence at 3.0 T.The concentration of glutamate(Glu), N-acetylaspartate(NAA), choline(Cho),and creatine(Cr) were determined using the jMRUI v.4.0 software.The correlation between metabolic concentration and HbA1c level were analyzed.Results The concentrations of Glu(P<0.01)and Cho(P=0.02) in the posterior cingulate cortex in T2DM patients show significantly increased when compared to the control group, while NAA significantly decreased(P=0.03). The HbA1c level was positively correlated with the concentrations of Glu(r=0.692,P=0.000) and inversely correlated with NAA(r=-0.628,P=0.001).Conclusion ~1H-MRS analysis using TE-averaged PRESS sequence indicates that T2DM may cause subtle changes in the metabolic profile of the posterior cingulate cortex, especially the Glu level.The elevated Glu and decreased NAA level might be related to hyperglycemia.更多还原