不同临床分级帕金森病多巴胺转运蛋白显像与UPDRS评分  

Dopamine transporter imaging in the different stages of Parkinson's disease and UPDRS score

作　　者：刘晓华[1] 谭建[1] 张富海[1] 肖茜[1] 贾强[1] 董峰[1] 

机构地区：[1]天津医科大学总医院核医学科,天津300052

出　　处：《天津医科大学学报》2006年第2期223-226,共4页Journal of Tianjin Medical University

摘　　要：目的:对不同H-Y分级帕金森病(PD)患者和正常对照者进行纹状体/小脑放射性计数比值的半定量分析,探讨纹状体/小脑的放射性计数比值与UPDRS评分及年龄之间的关系。方法:对58例PD患者(Hoehn&Yahr1级13例、1.5级9例、2级15例、2.5级10例、3级7例、4级4例)进行99Tmc-TRODAT-1 SPECT/CT脑断层融合显像。结果:(1)正常对照者壳核与尾核特异性摄取99Tmc-TRODAT-1无显著性差别。早期PD患者双侧壳核摄取99Tmc-TRO-DAT-1较尾状核减少的更为明显,3级和4级PD患者壳核/小脑与尾状核/小脑的放射性计数比值无明显差异。(2)PD患者纹状体摄取99Tmc-TRODAT-1随着疾病严重程度的增加而逐渐减少,纹状体特异性摄取99Tmc-TRODAT-1与UPDRS评分之间存在负相关(r=-0.827,P<0.001)。(3)对照组纹状体摄取99Tmc-TRODAT-1随着年龄的增加而逐渐减少。PD患者纹状体特异性摄取99Tmc-TRODAT-1与年龄之间不存在相关关系(r=-0.186)。结论:PD患者壳核神经末梢DAT的功能和密度最先受损,然后是尾状核,并累及整个纹状体。99Tmc-TRODAT-1 SPECT脑显像有助于PD的早期诊断,在评价疾病的严重程度及检测疾病进展等方面可作为UPDRS评分的有益补充。ABSTRACT Objective： To evaluate the correlation between striatum/cerebellum value ,UPDRS score and age. Methods： We took 9~ff^-TRODAT-1 SPECT/CT brain hybrid fusion imaging for 58 cases with Parkinson＇s disease （PD） （13 cases in H-Y stagel, 9 cases in stage 1.5, 15 cases in stage 2, 10 cases in stage 2.5,7 cases in stage 3, 4 cases in stage 4） and 13 cases without PD. Results： （1）There was no significant difference in the uptake of 9~ff^-TRODAT-1 between putamen and caudate in normal subjects. For PD patients in early stage, less uptake was seen in bilateral putamen than in caudate. （2）As disease develops, the uptake of 9~I^-TRODAT-1 in striatum was decreased prominently. A negative correlation between the uptake of 9~I^-TRODAT-1 and UPDRS score （r=-0.827, P〈0.001） was found.（3）The higher the age, the less uptake of 9~ff^-TRODAT-1 in striatum in normal subjects. No correlation between the age and the uptake in PD patients （r = -0.186） was found. Conclusion： DAT function and density in putamen are first injured, then the caudate, and implicates the entire striatum. 9~ff^-TRODAT-1 SPECT imaging is helpful for the early diagnosis of PD and is a beneficial complement to the UPDRS score in the assessment of the disease severity and monitoring PD progress.

关 键 词：帕金森病 ^99TC^M-TRODAT-1 单光子发射型计算机断层显像 多巴胺转运蛋白 半定量分析 

分 类 号：R742[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]