不对称静止性震颤患者脑多巴胺转运体代谢分析  

Metabolism of dopamine transporter in brain of patients with asymmetric resting tremor

作　　者：张蓉[1] 冯涛[1] 李鑫[1] 欧阳巧洪[2] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,100050 [2]解放军总医院第一附属医院核医学科

出　　处：《中华老年心脑血管病杂志》2012年第6期613-615,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市科委首都特色临床医学应用发展项目(Z111107058811012);北京市卫生系统高层次人才培养项目(2011-3-022)

摘　　要：目的本研究拟通过脑多巴胺转运体的正电子发射断层显像(PET)对不对称静止性震颤患者进行脑多巴胺转运体代谢特点进行分析,以指导临床诊断。方法筛选出不对称静止性震颤患者40例,每例受试者均进行脑^(11)C-甲基-N-2β-甲基酯-3β-(4 F-苯基)托烷(^(11)C-β-CFT)PET。根据PET结果 ,分为2组,无多巴胺能系统功能缺失的分子影像学证据(SWEDD)组6例,非SWEDD组34例。比较2组间临床特征的差异,分析不对称静止性震颤患者脑多巴胺转运体代谢的特点。结果 SWEDD组双侧纹状体对脑多巴胺转运体对比剂^(11)C-β-CFT摄取对称完整。非SWEDD组11例表现为纹状体对^(11)C-β-CFT不对称性摄取下降,23例表现为纹状体对^(11)Cβ-CFT对称性摄取下降。SWEDD组患者平均病程明显高于非SWEDD组[(9.42±11.40)年vs(3.64±2.70)年,P<0.05]。结论不对称静止性震颤患者的脑多巴胺转运体代谢存在异质性,部分患者扫描为SWEDD。进行脑多巴胺转运体分子影像学检查有助于鉴别SWEDD和帕金森病患者。Objective To study the metabolic characteristics of dopamine transporter in patients with asymmetric resting tremor by position emission computer（PET）-assisted tomography. Methods Forty patients with asymmetric resting tremor, who underwent PET-assisted tomography for the metabolism of 11C-β-CFT in their brain,were divided into scans without evidence of dopaminergic deficit（SWEDD） group（n=6）and non-SWEDD group（n= 34）. Metabolic characteristics of dopamine transporter were compared between the two groups. Results The uptake of 11 C-β-CFT,a dopamine transporter contrast medium,was symmetrical and intact in bilateral striatum of SWEDD group,and asymmetrical in bilateral striatum of non-SWEDD group,which was decreased in 11 patients of SWEDD group and in 23 patients of non-SWEDD group. The average disease course was significantly longer in SWEDD group than in non-SWEDD group（9.42± 11.40 years vs 3.64±2.70 years,P〈0.05）. Conclusion Metablism of dopamine transporter is heterogeneous in patients with asymmetric resting tremor. PET-assisted tomography can show dopaminergy deficit evidence in some of them. Dopamine transporter imaging helps to discriminate dopaminergy deficit evidence from Parkinson＇s disease.

关 键 词：震颤 帕金森病 多巴胺 正电子发射断层显像术 

分 类 号：R742.5[医药卫生—神经病学与精神病学]