不同临床分级帕金森病多巴胺转运蛋白显像研究  

Study of dopamine transporter imaging in different stages of Parkinson's disease

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：《生物医学工程与临床》2007年第2期118-121,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的了解不同Hoehn&Yahr(H-Y)分级帕金森病(Parkinson′s Disease,PD)患者及正常对照者纹状体对99Tcm-TRODAT-1的摄取能力,并进行纹状体/小脑的半定量分析。方法58例PD患者,其中男性24例,女性34例,年龄23～80岁(H-Y1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)。对照组13例,其中男性7例,女性6例,年龄44～72岁。进行99Tcm-TRODAT-1SPECT/CT脑断层融合显像。结果对照组双侧纹状体特异性摄取99Tcm-TRODAT-1差异无统计学意义(P=0.604>0.05)。对照组与不同H-Y分级PD患者纹状体/小脑的放射性计数比值差异均有显著统计学意义;H-Y分级为2.5级与3级PD患者(P=0.146)、3级与4级PD患者(P=0.284)间无统计学意义,其余不同H-Y分级PD患者组间纹状体/小脑的放射性计数比值之间差异均有显著统计学意义。H-Y分级为1级、1.5级、2级和2.5级的PD患者发病肢体对侧与同侧纹状体/小脑的放射性计数比值有显著统计学意义,发病肢体对侧纹状体摄取99Tcm-TRODAT-1减低更为明显。H-Y分级为3级和4级的PD患者发病肢体对侧与同侧纹状体/小脑的放射性计数比值均明显减低,二者无明显差异。结论PD患者临床症状的轻重与多巴胺和DAT特异性结合的下降程度相关。99Tcm-TRODAT-1SPECT脑显像有助于PD的早期诊断。Objective To evaluate the function of striatum and semi-quantitative analysis of striatum/cerebellum for uptaking ^99Tc^m-TRODAT-1 in patients with different stages of Parkinson＇s disease （PD）, Methods Fifty-eight PD patients, male 24 and female 34,aged 23 ～ 80 years（13 cases in H-Y stage 1,9 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 control group of 13 cases,male 7 and female 6,aged 44 ～ 72 years. The ^99Tc^m-TRODAT-1 SPECT/CT brain hybrid fusion imaging were performed in all cases. Results The images in normal subjects showed that no significant differences in uptake of ^99Tc^m-TRODAT-1 were found in both side of striatum （P= 0.604 〉 0.05）. The ratio of ^99Tc^m- TRODAT-1 uptake in striatum/cerebellum showed there were significant differences between the normal subjects and PD patients in different stages. Neither statistical significance of uptake in striatum/cerebellum were found between stage 2.5 and stage 3 （P = 0.146）, nor between stage 3 and stage 4 （P = 0.284）. There was statistical significance of uptake in striatum/cerebellum ratio among patients in the other stages. Statistical significance of uptake in striatum/cerebellum ratio was found between the striatum contralateral and ipsilateral to the limbs with symptoms or more affected, no matter the patients were in stage 1, stage 1.5, stage 2 or stage 2.5. Greater loss of striatal uptake was found in the contralateral limbs. For late stage PD patients （H-Y stage 3 or 4）, however, no significant difference of uptake in striatum/cerebellum ratio between contralateral and ipsilateral limbs was found. Conclusion It is demonstrated that the severity degree of clinical symptoms of PD patients is correlated with the decreasing degree of specific combination of dopamine with dopamine transporter. Thus the ^99Tc^m -TRODAT-1 SPECT imaging is helpful to the early diagnosis of PD.

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

分 类 号：R742.5[医药卫生—神经病学与精神病学] R817[医药卫生—临床医学]