权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Mechanism of hepatic encephalopathy: special reference to cognitive functions of cerebral cortex

肝性脑病的发病机制：特别涉及大脑皮层的认知功能

基本信息

批准号：
16590621
负责人：
KATO Akinobu
金额：
$ 2.24万
依托单位：
Iwate Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2006
项目状态：
已结题

项目摘要

We developed an easily conducted computoer-aided quantitative neuropsychiatric function test system for use in routine medical practice. We established normal values in healthy Japanese subjects and determined differences between healthy persons and liver cirrhosis patients without clinical encephalopathy in a multi-center clinical trial. The test system consist of eight tests : number connection test A and B, a figure position test, a digit symbol test, a block design test, and reaction test A, B and C. When the cut-off value was set at the 10^<th>/90^<th> percentile of the results in healthy subjects, the results of each of the 8 tests were abnornmal in about 25% of cirrhotic patients, and at least 1 of the 8 tests gave values greater than the 10^<th>/90^<th> percentile cut-off value in 58.2% of the 292 liver cirrhosis patients. Subclinical hepatic encephalopathy patients were thought to be included in thses 58.2% of patients. The developed test makes it possible to quantitatively as … More sess neuropsychiatric function and the results obtained can be use as a basis for the diagnosis of subclinical hepatic encephalopathyMagnetic resonance spectroscopic (MRS) studies have revealed abnormal metabolism in the brain of the patients with liver cirrhosis, including an invrease in total brain glutamine (Gin) and glutamate (Glu) levels (Glx). However, with conventional MRS techniques, it was difficult to separate the Glx signals. Using a high-magnetic field MR equipment and a newly developed data processing method, we attempted to separate the Glx signals on an MRS. Twenty-three patients with liver cirrhosis and 11healthy adults were enrolled in this study. After designating a region of interest in the occipital lobe gray matter of each subjects, 1H(proton)-MRS was performed using 3.0-tesla MR equipment. MRS conducted using the 3.0-tesla allowed Gln signals in the brain to be distinguished from the Glx signals. The brain signal intensity of Gln was found to be significantly higher in the liver cirrhosis group (0.658±0.23) than in the control group (0.473 ±0.08) (p<0.05). Neither the Glu nor Gln signals intensity showed any correlation with the blood ammonia level. High-magnetic field MRS allowed us to separate the Glx signals in the brain and revealed that the increase in the tital brain Glu and Gln levels in patients is solely attributable to an increase in the level of Gln. Less

我们开发了一个易于进行的计算机辅助定量神经精神功能测试系统，用于常规医疗实践。我们在日本健康受试者中建立了正常值，并在多中心临床试验中确定了健康人与无临床脑病的肝硬化患者之间的差异。该测试系统由八个测试组成：数字连接测试A和B，图形位置测试，数字符号测试，方块设计测试，反应测试A，B和C。当截断值设定为健康受试者结果的10^<th>/90^<th>百分位数时，约25%的肝硬化患者的8项检测结果均异常，292例肝硬化患者中有58.2%的患者8项检测中至少有1项检测的值大于10^<th>/90^<th>百分位数截断值。亚临床肝性脑病患者被认为包括在58.2%的患者中。开发的测试使得有可能定量地作为 ...更多信息磁共振波谱（MRS）研究发现肝硬化患者脑内代谢异常，包括全脑谷氨酰胺（Gln）和谷氨酸（Glu）水平（Glx）升高。然而，用传统的MRS技术，很难分离Glx信号。本文利用高磁场磁共振设备和新开发的数据处理方法，对23例肝硬化患者和11例健康成人的肝硬化磁共振图像进行了Glx信号分离。在每个受试者的枕叶灰质中指定感兴趣区域后，使用3.0特斯拉MR设备进行1H（质子）-MRS。使用3.0特斯拉进行的MRS允许将大脑中的Gln信号与Glx信号区分开。肝硬化组Gln脑信号强度（0.658±0.23）明显高于对照组（0.473 ±0.08）（p<0.05）。Glu和Gln信号强度与血氨水平无相关性。高磁场MRS使我们能够分离大脑中的Glx信号，并揭示患者后脑Glu和Gln水平的增加仅归因于Gln水平的增加。少