竺陈 荀冲 张晓军

    [摘要] 目的 探究1型糖尿病(T1D)對幼儿脑实质改变和认知功能的影响。 方法 纳入2017年1～12月南京医科大学附属儿童医院(以下简称“我院”)儿童内分泌遗传代谢科就诊的T1D患儿40例为T1D组，另随机选择来我院体检健康儿童40名为非T1D组。两组在行脑MRI检测前后，均接受糖化血红蛋白(HbA1c)检测。由专业人员对纳入研究的所有儿童进行IQ测试以及大脑神经发育相关评分。对所有儿童进行静息态功能磁共振(rsfMRI)扫描，采用SPM8软件对rsfMRI数据进行预处理，基于GIFT软件进行种子连接ICA分析。相关性分析采用Pearson相关性分析。 结果 两组IQ水平差异无统计学意义(P > 0.05)；大脑执行、学习记忆和处理能力评估中，评分较非T1D组患儿低，但差异无统计学意义(P > 0.05)，考虑样本量不足和/或观察评估年龄较小的因素。T1D组的个体中脑连接增加，体现在左侧额叶、左侧楔前叶，右侧小脑和左侧颞上回前部连接增加。这些异常连接与血高HbA1c水平、大脑认知功能之间不存在相关性(P > 0.05)。 结论 儿童T1D患者脑区之间连接增加，但与高HbA1c水平、大脑认知功能之间无明显相关性，可能与所纳入的研究样本量少、观察时间短等因素有关。

    [关键词] 静息态功能磁共振；1型糖尿病；儿童；相关性分析；认知障碍

    [中图分类号] R445 [文献标识码] A [文章编号] 1673-7210(2018)09(a)-0123-04

    [Abstract] Objective To study the effect of type 1 diabetes (T1D) on the brain parenchyma changes and cognitive function in children. Methods Forty children with T1D admitted in the Department of Childhood Endocrinology and Metabolism， the Affiliated Children′s Hospital of Nanjing Medical University (“our hospital” for short) from January to December 2017 were included as the T1D group. Another 40 children examined in our hospital for physical examination were involved in non T1D group. Both groups were detected blood HbA1c before and after MRI. All children enrolled in the study were underwent IQ tests and evaluated brain developmental-related scores by professionals. Resting state functional magnetic resonance (rsfMRI) scans were performed on both groups. The rsfMRI data were preprocessed by SPM8 software ......