Objective To explore the diagnostic and therapeutic value of magnetic resonance proton spectrum (MRS) and plasma concentration monitoring on patients with temporal lobe epilepsy. Methods From October 2010 to October 2013, in the Affiliated Hospital of Guilin Medical University ("our hospital " for short), 54 patients with temporal lobe epilepsy were selected and given plasma concentration monitoring, AEEG, MRI and MRS; at the same time, 20 healthy physical examination people in our hospital were selected as normal control and given AEEG, MRI and MRS. The metabolic products in hippocampus including N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were quantita-tively analyzed through MRS on bilateral hippocampus. Above all examination results were analyzed and compared. Results ①The results of AEEG, MRI and MRS in normal control were normal. Among 54 patients, abnormal AFFG were 31 cases (57.4%), hippocampus sclerosis from MRI were 19 cases (35.1%), abnormal MRS were 39 cases (72.2%), plasma concentration of 29 patients (53.7%) were within the effective therapeutic range, effective treatment were 32 cases(59.2%), ineffective treatment were 22 cases(40.7%).②The value of NAA/(Cr+Cho), NAA/Cr and NAA/Cho in the ab-normal side hippocampus of patients were significantly lower than that in the opposite side of hippocampus and normal control, the differences were statistically significant (P<0.05); the value of NAA/(Cr+Cho) and NAA/Cho in op-posite side were lower than those in the normal control, the differences were statistically significant (P < 0.05).③The value of NAA/(Cr+Cho), NAA/Cr and NAA/Cho of ineffective treatment patients were lower than those of treatment patients (P< 0.05 or P< 0.01), while there were no significant differences between within plasma concentration monitoring effective range and outside lasma concentration monitoring effective range. Conclusion MRS is more sensitive than MRI in diagnosis and location of epilepsy, MRS can increase the positive rate of early biochemical metabolism change in hippocampus in patients with partial seizure.%目的：探讨磁共振波谱(MRS)与血药浓度监测在颞叶癫痫诊断与治疗中的意义。方法选择2010年10月~2013年10月于桂林医学院附属医院(以下简称“我院”)诊治的颞叶癫痫患者54例，并进行抗癫痫药物血药浓度监测、动态脑电图(AEEG)、MRI和MRS检查；同时选择我院正常体检者20例作为正常对照，并进行AEEG、MRI和MRS检查。 MRS检测双侧海马N-乙酰天门冬氨酸(NAA)、肌酸复合物(Cr)和胆碱复合物(Cho)的水平。分析并比较两组的上述检查结果。结果①正常对照AEEG、MRI和MRS均正常；54例颞叶癫痫患者中，AEEG异常31例(57.4%)，MRI发现海马硬化19例(35.1%)，MRS异常39例(72.2%)，血药浓度在有效范围内29例(53.7%)，治疗有效32例(59.2%)，治疗无效22例(40.7%)。②颞叶癫痫患者病侧的NAA/(Cr+Cho)、NAA/Cr和NAA/Cho值低于对侧和正常对照，差异均有统计学意义(P<0.05)；患者对侧的NAA/(Cr+Cho)、NAA/Cho值低于正常对照(P<0.05)。③治疗无效的颞叶癫痫患者NAA/(Cr+Cho)、NAA/Cr和NAA/Cho值低于治疗有效的颞叶癫痫患者(P<0.05或P<0.01)，而血药浓度在有效范围内患者的NAA/(Cr+Cho)、NAA/Cr和NAA/Cho与有效范围外患者比较，差异无统计学意义(P>0.05)。结论 MRS可早期发现颞叶癫痫早期海马生化代谢异常，在早期诊断上有更高的敏感性。
展开▼
