路易体痴呆与帕金森病伴认知功能损害患者分子影像特点研究  

Molecular imaging characteristics of dementia with Lewy bodies and Parkinson's disease with cognitive impairment

作　　者：高中宝[1] 王炜[2] 陈彤[2] 富丽萍[3] 徐白萱[3] 王振福[2] GAO Zhong-bao WANG Wei CHEN Tong et al(Department of Geriactic Healthcare , Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院南楼保健科,北京100853 [2]解放军总医院南楼神经内科,北京100853 [3]解放军总医院核医学科,北京100853

出　　处：《中华老年心脑血管病杂志》2017年第8期793-796,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市科技计划(Z151100004015206);中央保健科研课题(W2013BJ14);解放军总医院临床科研扶持基金(2015FC-TSYS-1016);解放军总医院临床大数据基金(2016MBD-020)

摘　　要：目的探讨路易体痴呆与帕金森病伴认知功能损害(Parkinson's disease with cognitive impairment,PD-CI)患者分子影像特点。方法选择2014年2月~2016年12月解放军总医院南楼神经内科诊治的可能路易体痴呆患者6例及PD-CI患者15例,回顾分析临床病史、神经心理学特点以及^(11)C-甲基-N-2β-甲基酯-3β-(4-氟苯基)托烷(^(11)C-β-CFT)、^(11)C-匹兹堡复合物B(^(11)C-PIB)、^(11)C-雷氯必利(^(11)C-RAC)和18F-氟脱氧葡萄糖(18F-FDG)正电子发射断层显像特点。结果路易体痴呆患者双侧壳核^(11)C-β-CFT摄取对称性减低比例、皮质^(11)C-PIB摄取增高比例以及顶枕连接区18F-FDG下降比例明显高于PD-CI患者(50.0%vs 13.3%,80.0%vs 16.7%,100.0%vs 40.0%,P<0.05);而双侧壳核^(11)C-β-CFT摄取不对称性减低比例明显低于PD-CI患者(33.3%vs 86.7%,P<0.05)。3例行^(11)C-RAC显像的路易体痴呆患者中,双侧摄取减低1例(33.3%),双侧摄取增高2例(66.7%);15例(100.0%)PD-CI患者均呈现双侧摄取增高。结论路易体痴呆与PD-CI的分子影像特征性改变,有助于两者的鉴别诊断。Objective To study the molecular imaging characteristics of dementia with Lewy bodies（DLB）and Parkinson＇s disease with cognitive impairment（PD-CI）.Methods Six DLB patients and 15PD-CI patients admitted to our hospital from February 2014 to December 2016 were included in this study.Their clinical history,neuropsychological and ^（11）C-β-CFT,^（11）C-PIB,^（11）C-RAC,18F-FDG imaging characteristics were retrospectively analyzed.Results The rate of symmetrical reduction of ^（11）C-β-CFT uptake on bilateral putamen,radioactive retention of ^（11）C-PIB in extensive cerebral cortex and glucose metabolism reduction on connected area of parietal and occipital cortex was significantly higher while that of asymmetrical reduction of ^（11）C-β-CFT uptake on bilateral putamen was significantly lower in DLB patients than in PD-CI patients（50.0%vs 13.3%,80.0%vs16.7%,100.0%vs 40.0%,P〈0.05;33.3% vs 86.7%,P〈0.05）.Of the 3DLB patients who underwent ^（11）C-RAC,1（33.3%）showed a lower radioactive retention of ^（11）C-RAC in bilateral putamen and 2showed a higher radioactive retention of ^（11）C-RAC in bilateral putamen.The 15PD-CI patients（100.0%）showed a high radioactive retention of ^（11）C-RAC in bilateral putamen.Conclusion Molecular imaging can show the molecular characteristics of DLB and PD-CI,thus contributing to their differential diagnosis.

关 键 词：LEWY体病 帕金森病 认知障碍 神经心理学 氟脱氧葡萄糖F18 正电子发射断层显像术 早期诊断 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]