^(99)Tc^m-TRODAT-1多巴胺转运体SPECT显像在帕金森病中的临床应用  

Clinical application of ^(99)Tc^m-TRODAT-1 dopamine transporter SPECT imaging in patients with Parkinson's disease

作　　者：张红征[1] 李焕斌[1] 王玲[1] 文正伟[1] 张琦[1] 

机构地区：[1]温州医科大学,浙江温州325027

出　　处：《山东医药》2013年第44期17-19,共3页Shandong Medical Journal

基　　金：浙江省温州市科技局基金资助项目(Y20090094)

摘　　要：目的观察99Tcm-TRODAT-1多巴胺转运体(DAT)SPECT显像在帕金森病(PD)中的临床应用。方法 53例确诊PD患者及10例正常对照者行99Tcm-TRODAT-1显像,利用感兴趣区技术计算双侧纹状体/小脑、尾状核/小脑、壳核/小脑放射性比值,并与帕金森病统一量表(UPDRS)评分进行相关性分析;根据Hoehn&Yahr分级,分析不同病程PD患者纹状体放射性比值;以UPDRSⅢ评分标准分组,分析不同临床症状PD患者纹状体放射性比值;53例PD患者显像后正规内科治疗1 a并再次显像,分析治疗前后纹状体放射性比值的变化。结果 PD患者纹状体摄取99Tcm-TRODAT-1随病情严重程度增加而逐渐减少;纹状体DAT摄取比值与UPDRSⅡ、Ⅲ、Ⅴ和Ⅵ评分存在负相关(P均<0.01);强直与运动迟缓评分与DAT摄取比值呈负相关,震颤评分与DAT摄取比值不相关。治疗后PD患者纹状体摄取比值明显增高33例,未见明显变化15例,摄取降低5例。结论 99Tcm-TRODAT-1 DAT SPECT显像可用于PD的早期诊断及病程分期;与UPDRS量表结合,能更好地对PD患者进行诊断、分级和病情监测;在一定程度上,该显像方法还可作为药物疗效评价的客观指标。Objective To observe the clinical application of 99Tcm-TRODAT-1 dopamine transporter （DAT） SPECT imaging in patients with Parkinson＇s disease （PD）.Methods Fifty-three cases of patients with PD and 10 healthy controis underwent 99Tcm-TRODAT-1 SPECT imaging,the relationship between Unified Parkinson＇s Disease Rating Scale （UPDRS） score and the ratios of ST/CB,CN/CB,PT/CB calculated by ROI technology was analyzed.According to HoehnYhar classification,the radioactivity ratios of striatum in different stages were analyzed.Using UPDRS Ⅲ score,the relationship between the striatum radioactivity ratio of different clinical symptoms and UPDRS Ⅲ score was analyzed.The changes of before and after treatment （for 1 a） in striatum ratios were also analyzed.Results The uptaking of 99Tcm-TRODAT-1 in striatum decreased gradually as the increase of disease severity,and there was a negative correlation between the striatum radioactivity ratio and UPDRS Ⅱ,Ⅲ,Ⅴ and Ⅵ scores （all P ＜ 0.01）.There was a negative correlation between bilateral DAT uptaking ratio and the UPDRS Ⅲ score of ART and MT,but the TDT had no such relationship.After treatment,the uptaking ratio was significantly higher in 33 patients,no changes in 15 cases,and decreased in 5 cases.Conclusions 99Tcm-TRODAT-1 DAT SPECT imaging can be used for the early diagnosis and stages of PD.Combined with the UPDRS,it is better to diagnose,grade and monitor the patient＇s condition.In a certain extent,this imaging can also be used as the objective indicators for drug efficacy evaluation.

关 键 词：帕金森病 多巴胺转运体 99Tcm-TRODAT-1 帕金森病统一量表 SPECT 

分 类 号：R445.6[医药卫生—影像医学与核医学]