中国实用儿科杂志

中国实用儿科杂志 ›› 2012, Vol. 27 ›› Issue (4): 289-291.

• 论著 • 上一篇    下一篇

原发性遗尿症患儿智力结构分析及
基于体素的磁共振形态学研究

王    洪   

  1. 解放军第463医院，沈阳    110004
  • 出版日期:2012-04-06 发布日期:2012-04-16

Assessment of intelligence structure in children with primary nocturnal enuresis： a voxel-based morphometry study.

  • Online:2012-04-06 Published:2012-04-16

摘要：

目的    分析原发性遗尿症（PNE）患儿智力结构，探讨单纯PNE患儿灰质形态学改变状况。方法    2006年10月至2011年8月解放军第463医院儿科就诊的75例右利手PNE患儿（PNE组）及72名正常儿童（对照组），采用中国韦氏儿童智力量表（C-WISC）进行智力测试，计算言语智商（VIQ）、操作智商（PIQ）、总智商（FIQ）、记忆或不分心（M/C）因子等指标；而后进行高分辨率T1WI磁共振成像（MRI）扫描，采用VBM5工具包，对所有被试T1WI图像进行基于体素的形态学分析（VBM），采用t检验进行组间分析，比较单纯PNE患儿脑区激活状况与正常对照组相应脑区灰质密度（GMD）。结果    PNE组FIQ、VIQ和PIQ均正常，与对照组差异无统计学意义（P＞0.05）。PNE组M/C因子低于对照组［（100.80 ±16.83）与（92.73 ±18.46）］，差异有统计学意义（P＜0.01）；VBM分析表明，PNE患儿小脑左后部及右侧背侧前额叶（dLPFC）灰质密度程度明显低于对照组，差异有统计学意义（P＜0.001）。结论    PNE患儿智力结构不平衡，存在注意功能缺陷。左侧小脑及右侧dLPFC功能障碍与其注意功能缺陷有关。

关键词: 遗尿症, 磁共振成像, 记忆障碍

Abstract:

Objective    To assess the working memory impairment and explore the differential of gray matter MR density alterations in children with primary nocturnal enuresis（PNE）using voxel-based morphometry（VBM）method.Methods    75 right-handed PNE children（M/F=39∶36，average age 10.4±1.3 years） and 72 age-matched， right-handed，healthy controls（M/F=40∶32，10.0±1.2 years） were recruited for the study. First，intelligence tests were performed using Chinese Wechsler Young Children Scales of Intelligence（C-WISC） in PNE children and controls. The full intelligence quotient（FIQ），verbal IQ（VIQ），performance IQ （PIQ） and memory/caution（M/C）factor were measured.Voxel-based morphometry（VBM）of a high-resolution 3 Tesla，T1-weighted MR images，processed using VBM5，was performed in the PNE children and controls. Student t test was performed to test the differences of the gray matter density（GMD）of the PNE children and controls.Results    The FIQ，VIQ and PIQ in the PNE group were within the normal range and did not significantly differ from the control group.The M/C factor was statistically lower in the PNE group.Compared with normal controls，PNE children showed lower GMD in right dorsolateral prefrontal cortex（dLPFC）and left cerebellum（P＜0.001）.Conclusion    Impairment in working memory was detected in PNE children， and the structural abnormalities of  the right dLPFC and left cerebellum might involved in their deficits.

Key words: enuresis, magnetic resonance imaging, attention