【摘要】 目的 探讨急性期和慢性期下腰腿痛（LBLP）全脑灰质体积（GMV）的变化特点及其与临床量表评分的相关性。方法 前瞻性搜集25例急性期LBLP、47例慢性期LBLP和42名健康受试者（HC）的3D-T₁WI磁共振扫描数据。使用CAT12软件对数据进行基于体素的形态学分析，通过方差分析和两样本事后t检验进行组间比较（年龄、性别和颅内总容积为协变量）,P<0.001表示差异性极显著。将差异脑区的GMV与视觉模拟量表（VAS）评分、疼痛分级指数量表（PRI）评分、现有疼痛强度量表（PPI）评分、简易疼痛量表（BPI）评分、利兹神经病理性疼痛症状与体征评估量表（LANSS）评分、日本骨科协会评估量表（JOA）评分及病程进行偏相关分析。结果 与HC相比，急性期LBLP左侧小脑6区和右侧颞下回GMV增加，慢性期LBLP右侧小脑6区GMV增加（P<0.001）。相关性分析表明，BPI-情绪评分与急性期LBLP左侧小脑6区GMV呈显著正相关（r=0.603,P=0.003）; LANSS评分与慢性期LBLP右侧小脑6区GMV呈趋势正相关（r=0.318,P=0.036）。结论 LBLP患者在急性期和慢性期均存在疼痛相关的脑区GMV增加。更多还原

【Abstract】 Objective To explore the characteristics of gray matter volumes in the brain of low back-related leg pain（LBLP） in the acute and chronic phases,and their correlation with the clinical scale scores.Methods 3D-T₁WI magnetic resonance imaging（MRI） data of 25 acute LBLPs,47 chronic LBLPs,and 42 healthy subjects（HC） were prospectively collected.Data were subjected to voxel-based morphological analysis using CAT12 software,and between-group comparisons were conducted using ANOVA and two-sample post-hoc t-tests（age,sex,and total intracranial volume were covariates）.Partial correlation was used to measure the strength of a relationship between the region with altered gray matter volume（GMV） value and the Visual Analogue Scale（VAS） score,the Pain Rating Index（PRI） score,the Present Pain Intensity（PPI） score,the brief pain inventory（BPI） score,the Leeds Neuropathic Pain Symptom and Signs Assessment Scale（LANSS） score,the Japanese Orthopaedic Association（JOA） score,and the course of the disease.Results Compared with HCs,acute LBLP patients show an increased GMV in the left cerebellar 6 region and the right inferior temporal gyrus,while chronic LBLP patients show an increased GMV in the right cerebellar 6 region（P <0.001）.Correlation analysis showed that the BPI-mood score was significantly positively correlated with the GMV value of the 6 regions of the left cerebellum of LBLP in the acute phase（r=0.603,P=0.003）.The LANSS score showed a positive correlation with the GMV value of the right cerebellar 6 region of LBLP in the chronic phase（r=0.318,P=0.036）.Conclusion Increased pain-related GMVs were demonstrated in both acute and chronic LBLP patients compared with HCs.更多还原