利用氢质子磁共振波谱(¹H-MRS)探讨谷氨酸(Glu)水平的变化对轻度认知功能损害(MCI)的诊断价值。

应用1.5 T磁共振扫描仪对20例MCI患者、20例阿尔茨海默病(AD)患者、20例健康对照者(NC)行多体素¹H-MRS检查，测定受检者左侧大脑扣带后回、海马及额叶谷氨酸(Glu)与肌酸(Cr)的峰下面积，分析、比较各组间Glu/Cr比值的变化。组间各指标的比较采用单因素方差分析。

在左侧扣带后回，¹H-MRS显示MCI组及AD组Glu/Cr值分别为0.37±0.03及0.30±0.03，较NC组(0.42±0.03)明显降低，差异有统计学意义(F＝19.36，P<0.05)。在左侧海马区，MCI组Glu/Cr值为0.40±0.03，与NC组(0.41±0.03)差异无统计学意义，但AD组Glu/Cr值(0.32±0.03)明显降低，与NC组差异有统计学意义(F＝7.41，P<0.05)。在左侧额叶，MCI组及AD组Glu/Cr值(0.41±0.03、0.43±0.03)均较NC组(0.43±0.03)差异无统计学意义(F＝0.84，P>0.05)。

在¹H-MRS中，左侧扣带后回Glu含量的变化可能是诊断MCI的有效生化指标之一。

To explore the diagnosis value of quantitative analysis of glutamate(Glu) with mild cognitive impairment (MCI) by proton magnetic resonance spectroscopy (¹H-MRS).

According to the clinical diagnosis standard for cognitive function, the study group included 20 patients with mild cognitive impairment (MCI group, 9 males and 11 females) and 20 patients with Alzheimer′s disease (AD group, 10 males and 10 females), and the control group used 20 healthy volunteers (NC group, 9 males and 11 females). All of the patients and volunteers were scanned by multi voxel ¹H-MRS using rapid acquisition with relaxation enhancement (RARE) and point-resolved spectroscopy (PRESS) pulse sequence. The levels of the Glu and Cr were measured in the posterior cingulate gyrus, hippocampus and the frontal gyms cortex automatically by the NUTS-NMR Utility Transform Software. The ratios of Glu/Cr were calculated and compared among the groups. Comparisons of the cognitive function and the ¹H-MRS indexes among MCI, AD and NC group were conducted by single factor analysis of variance (one-way ANOVA), between two groups significantly compared with minimal difference method (LSD).

Gender, age, and the fixed number of year of the education comparison between each group had no statistical difference (P>0.05). MMSE detection showed that cognitive function in the MCI group was lower than that in the NC group, and difference was statistically significant (t=0.427, P<0.05). However, there was significant difference in cognitive function between AD and MCI groups (t=0.366, P<0.05). According to ¹H-MRS, Glu/Cr ratios of the posterior cingulate gyri region in AD (0.37±0.03) and MCI (0.30±0.03) groups were significantly decline compared with NC group(0.42±0.03), and different had statistical difference (t=0.271 and 0.652, P<0.05). However, there were no significant difference for Glu/Cr ratios of the hippocampus between MCI (0.40±0.03) and NC (0.41±0.03) groups (t=0.054, P>0.05), but the Glu/Cr ratios of the hippocampus region in AD (0.32±0.03) and NC groups were significantly different (t=0.594, P<0.05). There were no significant changes in Glu/Cr ratios among AD, MCI and NC groups (0.41±0.03, 0.43±0.03 and 0.43±0.03).

In ¹H-MRS test, Glu may be an effective biochemical index of the diagnosis of MCI. ¹H-MRS quantitative analysis provides the important basis for the early diagnosis of MCI.