早期未经替代治疗帕金森病患者脑多巴胺的单光子发射计算机断层扫描显像特点  

Characteristics of brain dopamine single photon emission computerized tomography imaging in patients with Parkinson disease untreated by replacement therapy at early stage

作　　者：郑佳[1] 张致峰[2] 

机构地区：[1]上海市第八人民医院神经内科,上海市200235 [2]解放军第二军医大学长海医院核医学科,上海市200433

出　　处：《中国临床康复》2005年第41期14-16,i0001,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨脑多巴胺转运体99Tcm-TRODAT-1与多巴胺D2受体131I- epidepride单光子发射计算机断层扫描显像在早期帕金森病中的临床应用价值。方法:选择2002/2004长海医院门诊收治的46例早期未经替代治疗的帕金森病患者(H-Y Ⅰ级22例,Ⅱ级24例),分别接受脑多巴胺转运体 99Tcm-TRODAT-1 与多巴胺D2受体131I-epidepride单光子发射计算机断层扫描断层显像,利用感兴趣区技术计算纹状体与枕叶、额叶的放射性比值。结果:46例全部进入结果分析。①脑多巴胺转运体99Tcm-TRODAT-1 单光子发射计算机断层扫描显像结果:Ⅰ,Ⅱ级患者起病肢体对侧纹状体-枕叶／枕叶和纹状体-额叶／额叶放射性比值较同侧明显降低 (P<0．05,0．001);Ⅱ级患者起病肢体对侧纹状体-枕叶／枕叶放射性比值明显低于Ⅰ级患者(0.33±9．99,0．75+0．18 F=4．121,P<0．05)。②脑D2 受体131I-epidepride单光子发射计算机断层扫描显像分析结果:Ⅰ,Ⅱ级患者起病肢体对侧纹状体-枕叶／枕叶和纹状体-额叶／额叶放射性比值较同侧明显增高(P<0．05,0．01);Ⅱ级患者起病肢体对侧纹状体-枕叶／枕叶放射性比值明显高于Ⅰ级(1．33±0．70,0．69±0.37,F=5.493,P<0．05)。结论:①多巴胺神经元突触前多巴胺转运体与H-Y分期呈负相关。②早期未经替代治疗的帕金森病患者突触前多巴胺转运体与突触后D2 受体呈明显负相关。③人脑多巴胺转运体99Tcm-TRODAT-1与D2受体 131I-epidepride单光子发射计算机断层扫描显像结合将有助于帕金森病的早期诊断及病情临测。AIM： To evaluate the clinical application values of dopamine transporter ^99Tc^m-TRODAT-1 and dopamine D2 receptor ^131I-epidepride single photon emission computerized tomography （SPECT） imaging in early Parkinson disease. METHODS： Forty-six patients with Parkinson disease untreated by replacement at early stage （22 cases of H-Y Ⅰ stage and 24 cases of H-Y Ⅱ stage）, who were selected from the outpatient clinic of Changhai Hospital, accepted ^99Tc^m-TRODAT-1 SPECT and dopamine D2 receptor ^131I-epidepride SPECT imaging, and the ratios between striatum and occipital cortex （ST-OC/OC） and hetween striatum and frontal cortex （ST-FC/FC） were calculated with region-of-interest analysis. RESULTS： All the 46 patients were involved in the analysis of results. ① Results of dopamine transporter ^99Tc^m-TRODAT-I SPECT imaging： The contralateral ST-OC/OC and ST-FC/FC ratios of the affected limb were obviously decreased as compared with the ipsilateral ones in the patients of stages Ⅰ and Ⅱ（P〈 0.05,0.001）. The contralateral ST-OC/OC ratio was obviously lower in the patients of stage Ⅱ than in those of stage Ⅰ （0.33±9.99, 0.75±0.18, F=4.121, P〈 0.05）. ②Results of D2 receptor ^131I-epidepride SPECT imaging analysis： The contralateral ST-OC/OC and ST-FC/FC ratios of the affected limb were obviously increased as compared with the ipsilateral ones in the patients of stagesⅠ andⅡ （P〈 0.05, 0.01）. The contralateral ST-OC/OC ratio was obviously higher in the patients of stageⅡthan in those of stage Ⅰ （1.33±0.70, 0.69±0.37, F=5.493, P〈0.05）. CONCLUSION： ①The dopamine neuron before synapse dopamine transporter is positively correlated with H-Y staging. ② The before synapse dopamine transporter has obvious negative correlation with after synapse D2 receptor. ③ The combination of human brain dopamine transporter ^131Tc^m-TRODAT-1 SPECT and dopamine D2 receptor ^131I-epide- pride SPECT imaging will help the early diagnosis and disease condition monitoring

关 键 词：帕金森病 体层摄影术 发射型计算机 单光子 受体 多巴胺D2 

分 类 号：R742.5[医药卫生—神经病学与精神病学]