【摘要】 目的 探究多体素磁共振波谱（MRS）对脐血单个核细胞(UCB-MNC)治疗孤独症谱系障碍（ASD）儿童脑生化代谢物变化及其与儿童孤独症评定量表（CARS）评分变化的相关性。方法 采用MRS对2021年8月至2022年7月收治的20例3～8岁ASD儿童于UCB-MNC治疗前和治疗后3～12个月进行波谱分析，对比不同脑区N-乙酰天门冬氨酸(NAA）、胆碱（Cho）、肌酸（Cr)代谢物变化，并分析代谢物变化与CARS评分变化的相关性。结果 经UCB-MNC治疗后,20例ASD儿童中有17例CARS评分降低,1例无明显变化，2例略升高。20例ASD儿童治疗后CARS评分低于治疗前（P<0.01）。MRS显示17例ASD儿童双侧额叶、双侧小脑半球、双侧背侧丘脑NAA水平较治疗前显著提高（P<0.05,P<0.01），并且双侧额叶与双侧背侧丘脑NAA水平变化与CARS评分变化呈负相关（P<0.01）；双侧小脑半球NAA水平变化与CARS评分变化无显著关联（P>0.05）。19例ASD儿童右侧背侧丘脑Cho水平明显升高（P<0.05）,17例ASD儿童左侧额叶Cr水平明显升高（P<0.05），二者水平变化与CARS评分变化均无明显相关性（P>0.05）。其余脑区顶叶、枕叶、海马、杏仁核均未发现上述代谢物水平有明显变化。结论 UCB-MNC治疗早期，大部分ASD儿童部分脑代谢物发生变化，并与临床症状改善有相关性。UCB-MNC对ASD儿童治疗具有积极作用，MRS在其疗效评估中具有重要的参考价值。更多还原

【Abstract】 Objective To investigate the changes in cerebral biochemical metabolite levels of children with autism spectrum disorder(ASD) before and after treatment with umbilical cord blood mononuclear cells(UCB-MNC) and their correlation with the changes in the Childhood Autism Rating Scale(CARS) scores. Methods Multivoxel magnetic resonance spectroscopy(MRS) was used to conduct spectral analysis on 20 children aged 3 to 8 years with ASD who were admitted from August 2021 to July 2022 before UCB-MNC treatment and at 3 to 12 months after treatment. Changes in N-acetylaspartic acid(NAA), choline(Cho), and creatine(Cr) metabolites in different brain regions were compared, and the correlation between the changes in metabolites and the changes of CARS scores was analyzed. Results After UCB-MNC treatment, among the 20 children with ASD, there was decreased CARS scores in 17 patients, no significant change in 1 patient, and slight increase in 2 patients. The CARS scores of 20 children with ASD after treatment were lower than those before treatment(P<0.01). MRS revealed that the NAA levels in the bilateral frontal lobes, bilateral cerebellar hemispheres, bilateral dorsal thalamus and other brain regions of 17 children with ASD were significantly increased compared with those before treatment(P<0.05, P<0.01), and the changes in NAA levels in the bilateral frontal lobes and bilateral dorsal thalamus were negatively correlated with the changes in CARS scores(P<0.01). The changes in NAA levels in both cerebellar hemispheres were not significantly associated with changes in CARS scores(P>0.05). The Cho level in the right dorsal thalamus was significantly increased in 19(95%) children with ASD(P<0.05), and the Cr level in the left frontal lobe was significantly increased in 17(85%) children with ASD(P<0.05); there was no significant correlation between the changes in the levels of the above two indicators and the changes in CARS scores(P>0.05). No significant changes in the levels of the above metabolite levels were found in the other brain regions such as the parietal lobe, occipital lobe, hippocampus and amygdala. Conclusion In the early stage of UCB-MNC treatment, alterations in certain brain metabolites are observed in the majority of children with ASD, which is correlated with the improvement of clinical symptoms. UCB-MNC has a positive effect on the treatment of children with ASD, and MRS has important reference value in the evaluation of its therapeutic effect.更多还原