帕金森病^99mTc-TRODAT-1多巴胺转运体单光子计算机断层摄影脑显像研究  

Study on the ^(99m)Tc-TRODAT-1 DAT SPECT imaging of dopamine transporter in Parkinson's disease

作　　者：王丽敏[1] 王丽娟[1] 乔穗宪[2] 张玉虎[1] 赵洁皓[1] 

机构地区：[1]广东省医学科学院广东省人民医院神经内科广东省神经科学研究所,广州510080 [2]广东省医学科学院核医学科,广州510080

出　　处：《中华老年心脑血管病杂志》2010年第9期782-784,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(30870863,30801219);广东省科技计划项目基金(2007B031501004,2009B030801251);广东省自然科学基金(7001198);广东省医学科研基金(A2009038)

摘　　要：目的应用^(99m)Tc-TRODAT-1多巴胺转运体(DAT)单光子计算机断层摄影(SPECT)脑显像,研究不同运动障碍亚型帕金森病(Parkinson's diseas e,PD)纹状体生化改变。方法选择不同运动障碍亚型PD患者68例,其中震颤为主型PD患者36例(震颤PD组),姿势异常步态障碍(PIGD)为主型PD患者32例(PIGD PD组),分别行^(99m)Tc-TRODAT-1 DAT SPECT脑显像,利用感兴趣区技术计算首发症状对侧纹状体与小脑的特异性放射性比值。结果 PIGD PD组患者首发症状对侧纹状体、小脑较震颤PD组患者明显降低(1.43±0.92) vs (1.49±0.10),P<0.05]。纹状体、小脑下降与PIGD评分呈负相关(r=-0.73,P<0.05),而与震颤评分无明显相关性(r=-0.21,P>0.05)。结论不同运动障碍亚型PD患者^(99m)Tc-TRODAT-1 DAT SPECT脑显像存在明显的异质性,PIGD为主型PD患者纹状体DAT的功能降低更明显,提示不同运动障碍亚型PD有不同的生化病理基础。Objective To investigate the biochemical change of striatum by ^99mTc-TRODAT-1 DAT SPECT imaging in Parkinson＇s disease（PD） with different subtypes of movement disorder. Methods Sixty-eight PD patients with different subgroups of movement disorder were studied by ^99mTc-TRODAT 1 DAT SPECT imaging. Of them, 36 tremor-dominant PD patients and 32 postural instability-gait disorder（PIGD）-dominant PD patients were detected. Striatum-specific uptake of ^99mTc-TRO DAT-1 was calculated according to the ratio of DAT uptake in striatum（ST） and cerebellum（CB）. Results In the PIGD-dominant PD group,the DAT specific uptake of ^99mTc- TRODAT-1 was significantly lower than that in the tremor dominant PD group[（1. 43±0.92） vs （1.49±0.10）, P 〈 0. 05]. There was negative correlation between the ST/CB radiation ratio and the PIGD score of UPDRS （r =-0.73,P 〈 0.05） ,but no relationship between tremor score and ST/CB ratio （r =- 0.21,P〉 0.05）. Conclusions The results indicate that there is significant difference in the striatum-specific uptake of ^99mTc-TRODAT 1 between the tremor-dominant PD and PIGD-dominant PD and the decrease in the striatum specific uptake of ^99mTc-TRODAT-1 is more sinifieant in the PIGD-dominant PD, suggesting that there is different biochemical pathologic basis between different movement disorder subgroups of PD.

关 键 词：帕金森病 运动障碍 多巴胺 体层摄影术 发射型计算机 单光子 锝 

分 类 号：R742.5[医药卫生—神经病学与精神病学]