Evaluation of Mental Disorders Using Proton Magnetic Resonance Spectroscopy in Dialysis and Predialysis Patients
Evaluation of Mental Disorders Using Proton Magnetic Resonance Spectroscopy in Dialysis and Predialysis Patients
复制标题
使用质子磁共振波谱对透析和透析前患者的精神障碍进行评估
DOI：
10.1159/000484023
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发表时间：
2017
影响因子：
2.8
通讯作者：
He Fang-Fang
中科院分区：
文献类型：
--
作者：
Zhang Chun-Yun;Chen Ying;Chen Shan;Kong Xiang-Chuang;Liu Yuan;You Chao-Qun;Wan Cheng;Bondzie Philip A.;Su Hua;Zhang Chun;He Fang-Fang
背景/目的慢性肾脏病（CKD）患者普遍存在心理并发症。本研究旨在调查4-5期CKD患者的精神障碍，并应用质子磁共振波谱（1H-MRS）技术检测患者脑内代谢物浓度，比较不同透析治疗对终末期肾病（ESRD）患者精神障碍的影响。腹膜透析患者（12例）。收集患者的年龄、性别、血红蛋白（Hb）和甲状旁腺激素（PTH）水平等基线资料。透析前患者作为对照组。采用三种心理量表对三组患者的心理状况进行评估。采用1H-MRS检测患者双侧杏仁核、海马和单侧前扣带回皮质（ACC）内代谢物的相对浓度。1H-MRS改变主要发生在ACC，HD患者ACC中含胆碱化合物相对于肌酸（Cho/Cr）、肌醇相对于肌酸（MI/Cr）和谷氨酸和谷氨酰胺相对于肌酸（Glx/Cr）的比值较高。1H-MRS结果与基线资料及心理量表评分相关。结论CKD患者存在不同类型的精神障碍及脑内代谢紊乱。代谢物浓度与心理状态相关，HD组优于透析前和PD组。
Background/AimsPsychological complications are prevalent in patients with chronic kidney disease (CKD). This study aimed to investigate mental disorders in stage 4-5 CKD patients, to detect metabolite concentrations in the brain by proton magnetic resonance spectroscopy (1 H-MRS) and to compare the effects of different dialysis therapies on mental disorders in end-stage renal disease (ESRD).MethodsThe sample population was made up of predialysis (13), hemodialysis (HD)(13), and peritoneal dialysis (PD) patients (12). We collected the baseline data of patients’ age, sex, hemoglobin (Hb) and parathyroid hormone (PTH) levels. The predialysis patients served as the control group. The psychological status of the three groups was assessed using three psychological scales. 1 H-MRS was used to evaluate the relative metabolite concentrations in the bilateral amygdala, hippocampus and unilateral anterior cingulated cortex (ACC).ResultsThe psychological status was better in HD patients than in predialysis and PD patients. 1 H-MRS alterations were predominantly found in the ACC. Choline-containing compounds relative to creatine (Cho/Cr), myo-inositol relative to creatine (MI/Cr) and glutamate and glutamine relative to creatine (Glx/Cr) in the ACC were higher in HD patients. 1 H-MRS results were correlated with the baseline data and the scores of psychological scales.ConclusionsCKD patients showed different types of mental disorders as well as metabolite disturbances in the brain. The metabolite concentrations correlated with the psychological status which was better in HD than in predialytic and PD patients.