目的：通过磁共振氢质子波谱（1H-MRS）检测阻塞性睡眠呼吸暂停低通气综合征（OSAHS）颞横回听皮层区的神经代谢产物N-乙酰天门冬氨酸／胆碱（ NAA／Cho ）变化情况，以寻找听力损伤的早期预警指标。方法随机抽取PSG确诊OSAHS患者80例，经纯音听阈筛查将OSAHS患者分为双侧耳聋组（n＝26）、单侧耳聋组（n＝15）以及单纯OSAHS组（n＝39），选择健康志愿者19例作为正常对照组，1 H-MRS检测上述各组双侧颞横回听皮层NAA／Cho的变化；利用ROC曲线下面积＞50％判定NAA／Cho作为早期提示OSAHS患者合并感音神经性听力损伤的特异度及灵敏度。结果与正常对照组比较，单、双侧耳聋组NAA／Cho降低（ P均＜0．05）；与单纯OSAHS组相比，单侧、双侧耳聋组NAA／Cho降低（P均＜0．05）；而单侧耳聋组患侧与自身健侧NAA／Cho比较无统计学差异（P＞0．05）；ROC曲线测定NAA／Cho曲线下面积为78％。结论颞横回听皮层区神经代谢产物NAA／Cho有可能作为提示OSAHS患者感音神经性听力损伤发生的早期预警指标。%Objective To explore the changes of NAA/Cho in transverse temporal gyrus with 1 H-MRS in obstructive sleep apnea hypopnea syndrome ( OSAHS) patients for looking for early warning indicators of hearing damage .Methods 80 patients with OSAHS confirmed by PSG were divided into bilateral deafness group (n =26), unilateral deafness group(n =15) and simple OSAHS group (n =39); 19 healthy volunteers were as normal control group .1 H-MRS was used todetect NAA/Cho in transverse temporal gyrus of the above groups , then compared with each group; the area under ROCcurve of >50% was used to judge the specificity and sensitivity of NAA /Cho as early tips for OSAHS patients with sensorineuralhearing loss.Results Compared with normal control group, OSAHS with (bilateral and unilateral) deafness groupsauditory cortex NAA/Cho decreased (all P <0.05); compared with the simple OSAHS group, OSAHS groups with (bilateraland unilateral) deafness NAA /Cho also decreased (all P <0.05); while there was no significant difference betweenipsilateral and contralateral transverse temporal gyrus in unilateral deafness OSAHS group (P >0.05).The area of NAA/Cho under the ROC curve was 78%.Conclusion In transverse temporal gyrus, nerve metabolites cortex NAA /Cho mayserve as early warning indicator to prompt OSAHS patients with sensorineural hearing damage occur .
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