目的 探讨不同程度全面性发育迟缓患儿额叶、海马区代谢物特点,并探索其与认知功能水平的相关性。方 法 纳入66例头颅磁共振成像无明显异常的全面性发育迟缓患儿,采用Gessell发育诊断量表评估认知功能水平,并根据 发育商(DQ)分为轻度发育迟缓组(24例)、中度发育迟缓组(20例)、重度发育迟缓组(22例);利用磁共振波谱(MRS)技术, 选择双侧额叶白质、海马区为感兴趣区,计算其中N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、NAA/(Cho+Cr) 的相对值,比较轻度、中度、重度发育迟缓组的代谢物水平,并探讨其与病情程度、认知功能的相关性。结果 三组患儿的 双侧额叶白质以及海马区NAA/Cr、Cho/Cr、NAA/(Cho+Cr)水平的差异均无统计学意义(P>0.05)。 各代谢物相对水平与 病情程度、认知功能均无显著相关性(P>0.05)。 结论 选择额叶白质及海马区行MRS检查,对评估全面性发育迟缓患儿 的疾病严重程度及认知功能的价值不大。
Objective To explore the characteristics of metabolites in the bilateral frontal white matter and hippocampus of children with different degrees of global developmental delay (GDD) and to explore their correlation with cognitive function. Method Sixty-six children with GDD who had no obvious abnormalities by cranial magnetic resonance examination were enrolled. The cognitive function was assessed by Gessell developmental schedule. According to the developmental quotient (DQ), they were divided into mild developmental delay group (24 cases), moderate developmental delay group (20 cases), and severe developmental delay group (22 cases). The magnetic resonance spectroscopy (MRS) technique was used to calculate the relative values of N-acetylaspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), NAA/(Cho+Cr) in the bilateral frontal white matter and hippocampus which were selected as regions of interest. The metabolite levels in mild, moderate and severe developmental delay groups were compared and their correlation with disease severity and cognitive function was discussed. Results There was no difference in the levels of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) in bilateral frontal white matter and hippocampus among the three groups (P>0.05). Metabolite concentrations were not associated with disease severity and cognitive function (P>0.05). Conclusion MRS examination of the bilateral frontal white matter and hippocampus in children with global developmental delay is of little value in evaluating the disease severity and cognitive function.