特发性震颤和帕金森病患者脑黑质高回声的相关性研究  

Correlation of substantia nigra hyperecho with essential tremor and Parkinson disease

作　　者：高红铃 薛峥[1] 陶安宇[2] 杨清梅[1] 毛志娟[1] Gao Hongling;Xue Zheng;Tao Anyu;Yang Qingmei;Mao Zhijuan(Department of Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Ultrasonography,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430000 [2]华中科技大学同济医学院附属同济医院超声影像科,武汉430000

出　　处：《中华全科医师杂志》2019年第4期365-368,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨黑质高回声在特发性震颤(ET)和帕金森病(PD)的临床特点及其相关性。方法回顾性分析2016年3月至2018年3月华中科技大学同济医学院附属同济医院诊治、中脑超声检查资料完整的158例ET、PD患者的临床资料。其中ET患者35例(ET组),既往无ET病史的单纯PD患者113例(PD组),既往有ET病史的PD患者10例(既往诊断ET病史>10年,5例有家族史,ET-PD组)。以同期58例健康体检者为健康对照(对照组)。比较各组中脑黑质高回声的面积情况。结果(1)较大侧黑质高回声面积[M(Q1,Q3)]依对照组[0(0,0)cm^2]、ET组[0.27(0,0.41)cm2]、ET-PD组[0.33(0.21,0.40)cm^2]、PD组[0.35(0.29,0.45)cm^2]的顺序增加,其中对照组与ET组、ET组与PD组比较差异均有统计学意义(Z=-5.24,P<0.01;Z=-3.09,P=0.02),而ET组与ET-PD组、ET-PD组与PD组比较差异均无统计学意义(Z=0.98,P=0.32;Z=-0.77,P=0.43)。(2)ET-PD组黑质高回声阳性(9例)与黑质高回声阴性患者(1例)的比值为9.00,ET组则为0.94,故与ET组相比,ET-PD组黑质高回声阳性的OR值为9.53(95%CI:1.09~83.43),有统计学意义(χ^2=3.91,P=0.04)。结论黑质高回声是ET和PD相关性的临床影像学反映,具有鉴别诊断价值。Objective To investigate the correlation of substantia nigra hyperecho with essential tremor(ET)and Parkinson disease(PD).Methods The clinical data of 158 patients with ET or PD who underwent transcranial ultrasonography in Tongji Hospital from March 2016 to March 2018 were retrospectively analyzed.There were 35 patients with ET(ET group),113 patients with PD who had no previous history of ET(PD group),and 10 PD patients with previous history of ET(ET-PD group).And 58 healthy subjects served as controls(control group).The hyperechoic area of substantia nigra in different groups was compared.Results The hyperechoic areas of the substantia nigra were[0(0,0)]cm^2(control group),[0.27(0,0.41)]cm^2(ET group),[0.33(0.21,0.40)]cm^2(ET-PD group)and[0.35(0.29,0.45)]cm^2(PD group);the differences between control group and ET group,between the ET group and PD group were statistically significant(Z=-5.24,P=0.01;Z=-3.09,P=0.02),and there were no significant difference between the ET group and ET-PD group,between ET-PD group and PD group(Z=-0.98,P=0.32;t=-0.98,P=0.33).The ratio of substantia nigra hyperechoic positive to negative in ET-PD group was 9.00(9/1),while that in ET group was 0.94(17/18)(OR=9.53,95%CI:1.09-83.43,χ^2=3.91,P=0.04).Conclusion Substantia nigra hyperecho is an objective imaging indicator for patients with ET and PD,and has a certain differential value for their diagnosis.

关 键 词：特发性震颤 帕金森病 黑质 超声检查.多普勒.经颅 

分 类 号：R742.5[医药卫生—神经病学与精神病学]