帕金森病患者中枢多巴胺D_2受体SPECT显像研究  

Imaging of D2 Dopamine Receptors of Patients With Parkinson's Disease by Using Single Photon Emission Computed Tomography

作　　者：王坚[1] 蒋雨平 吕传真[1] 王新德[2] 郑剑晖[2] 吴春英[3] 王博诚[3] 张伟 

机构地区：[1]上海医科大学神经病学研究所,200040 [2]北京医院脑系科,100730 [3]江苏省原子医学研究所核医学国家重点实验室,214063 [4]苏州医学院附一院核医学科,215004

出　　处：《中国临床神经科学》1998年第2期76-81,共6页Chinese Journal of Clinical Neurosciences

基　　金："九五"攻关资助课题(96-906-95-08)

摘　　要：建立人中枢多巴胺D_2.受体(DRD_2)SPECT功能显像的方法;了解帕金森病(PD)患者中枢DRD_2的功能状态及其诊断意义.静脉注射^(131)I-IBZM 2h后,SPECT扫描,记录脑DRD_2显像,选择基底节(BG)/枕叶(OC)和基底节(BG)/额叶(FC)作为反映基底节DRD_2功能的半定量指标.^(131)I-IBZM高度特异性地在双侧基底节浓聚.6例早期PD患者中,病侧肢体对侧的BG/OC和BG/FC比值较同侧BG/OC和BG/FC大(P<0.01);长期服用多巴制剂的6例中晚期PD患者,双侧BG/OC和BG/FC比值无明显差异,但低于对照组(P<0.01).I-IBZM-SPECT可以显示DRD_2的功能状态.早期PD患者病侧基底节DRD_2上调,长期应用多巴制剂的中晚期PD双侧基底节DRD_2减少.DRD_2的检测有助于PD的早期确诊.To set up the method of testing the functional state of the striatal D2 dopamine receptors (DRD2) in patients with Parkinson's disease (PD) and to elucidate its usefulness in diagnosing PD. Four control subjects ,six patients with early unmedicated PD and six patients with moderate or advanced PD treated with long-term oral L-Dopa were investigated. SPECT was performed 2 hours after intravenous injection of 2. 7mci 131I -IBZM, then the ratio ofbasal ganglia to occipital cortex (BG/OC) and ratio of basal ganglia to frontal cortex (BG/ FC)were calculated as semiquantative parameter of striatal D2 dopamine receptor's function. The SPECT images revealed specific regional uptake in the basal ganglia. In the early unmedicated PD group, the BG/OC and BG/FC rates were significantly higher in the striatum contralateral to the parkinsonism. In the moderate or advanced medicated PD group, no significant differences were observed bilaterally, and the BG/OC and BG/FC rates of this group were lower than those of the control. 131I -IBZM-SPECT imaging is useful in evaluating the functional state of DRD2. There is DRDZ up-regulation in the striatum contralateral to the parkinsonism of patients with early unmedicated PD, which may help to confirm the diagnosis of PD at the early stage. The DRD2 were decreased in the bilateral striatum of patients with moderate or advanced PD treated with long-term oral L-Dopa.

关 键 词：多巴胺D2 受体 SPECT 震颤麻痹 

分 类 号：R742.504[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]