帕金森病^99mTc-TRODAT-1多巴胺转运蛋白显像及与UPDRS评分相关性研究  

Dopamine transporter imaging study of patients with Parkinson's disease and the correlation with different UPDRS score

作　　者：李焕斌[1] 张雄[2] 王玲[1] 张琦[1] 

机构地区：[1]温州医学院核医学教研室,浙江温州325027 [2]温州医学院附属第二医院神经内科,浙江温州325027

出　　处：《中国医学影像技术》2008年第5期773-776,共4页Chinese Journal of Medical Imaging Technology

基　　金：温州市科技局资助项目(Y2005A020)资助

摘　　要：目的研究99mTc-TRODAT-1多巴胺转运蛋白SPECT显像与PDUPDRS评分相关性,以探讨其在帕金森病(PD)病情与病程监测中的价值。方法24例临床确诊PD患者和10例对照者,进行99mTc-TRODAT-1多巴胺转运蛋白显像,计算纹状体与小脑、尾状核与小脑及壳核与小脑放射性计数比值;应用UPDRS对患者的运动功能进行评分,将UPDRSⅡ、Ⅲ、Ⅴ和Ⅵ的评分分别与起病肢体对侧、同侧及双侧纹状体/小脑放射性计数进行相关性分析。根据Hoehn-Yhar分级,将24例PD患者分为早期、中期和晚期,分析不同病程纹状体放射性比值。结果PD患者纹状体摄取99mTc-TRODAT-1随病情严重程度增加而逐渐减少,与UPDRSⅡ、Ⅲ、Ⅴ和Ⅵ评分之间存在负相关(r=-0.608,-0.671,-0.661,-0.639,P均<0.05);PD病程越晚,CN/CB及PT/CB放射性摄取比值越低。结论99mTc-TRODAT-1SPECT转运蛋白显像可用于PD的早期诊断及病程分期,纹状体/小脑放射性计数比值作为PD诊断及监测病情轻重的半定量分析指标,与UPDRS评分具有相关性,在一定程度上可作为病情进展情况的预判和客观随访指标。Objective To evaluate the patient＇s condition and course of desease by studying the relationship of ^99mTc-TRO- DAT-1 SPECT imanging with UPDRS score. Methods Twenty-four PD patients and 10 controls received ^99mTc-TRODAT- 1 dopamine transporter imaging. The region of interest of strialiam, as well as CN and PT, were drawn by two experienced nuclear medicine specialist. Semiquantiative analysis methods were used to calculate the radioactive uptake ratio, and the DAT differeances of all ROIs were compared. We also used United Parkinson Disease rating scale to assess movement function of PD patients. Then the relationship between the subscales of UPDRS Ⅱ , Ⅲ, Ⅴ, Ⅵ and striatum/cerebellum were analysed. Results For group of PD.- the ST/CB, as well as CN/CB and PT/CB all decreased. As disease develops, the uptake of ^99m Tc-TRODAT-1 in striatum decreased gradually. There ＇was a negative correlation bet.ween ST/CB ratios＇and UPDRS scores（r= -0. 608, -0. 671, -0. 661, -0. 639, P^0. 05）. Conclusion ^99mTc-TRODAT-1 DAT SPECT showed the value not only in the diagnose of early stage PD, but also in the evaluation of disease course. ST/CB radio ligand binding ratios can be used as a kind of semiquantiative index when diagnosing and evaluating severity of PD. It is helpful to monitor PD progress and correlated to the UPDRS scores to some extent.

关 键 词：帕金森病 UPDRS 99mTc-TRODAT-1 体层摄影术 发射型计算机 单光子 

分 类 号：R817.492[医药卫生—影像医学与核医学]