脑深部电刺激治疗帕金森病的临床研究  

Clinical study of deep brain stimulation in the treatment of Parkinson′s disease

作　　者：周彬[1] 李波[1] 匡卫平[1] 刘博[1] 黄红星[1] 李小松 王枭冶 邹叔骋[1] Zhou Bin;Li Bo;Kuang Weiping;Liu Bo;Huang Hongxing;Li Xiaosong;Wang Xiaoye;Zou Shucheng(Department of Neurosurgical,Hunan Brain Hospital,Changsha 410007,China)

机构地区：[1]湖南省脑科医院神经外科,长沙410007

出　　处：《中国医师杂志》2021年第12期1782-1785,共4页Journal of Chinese Physician

基　　金：湖南省科技重大专项项目(2018SK1030);湖南省自然科学基金项目(2019JJ80024,2019JJ80027,2020JJ8081);湖南省创新引导计划(2018SK50605,2017SK50317)。

摘　　要：目的研究脑深部电刺激(DBS)治疗帕金森病(PD)的临床效果。方法选择2016年1月至2018年12月在湖南省脑科医院治疗的PD患者32例进行研究。同时选择同期来院体检的20例体检健康者为对照组,通过MRI导向,辅以电生理刺激矫正靶点,对PD患者行丘脑底核DBS治疗。根据治疗前后Webster和统一帕金森病评定量表(UPDRS)评分比较临床治疗效果,并比较治疗前后β-淀粉样蛋白1-42(Aβ1-42)、IL-1β、IL-6、尿酸(UA)、丙二醛(MDA)、同型半胱氨酸(Hcy)、S-亚硝基化动力蛋白相关蛋白1(SNO-Drp1)与动力蛋白相关蛋白1(Drp1)的含量以及SNO-Drp1/Drp1比值。结果PD患者治疗后的Webster评分和UPDRS评分均低于治疗前(P<0.05);且PD患者治疗后的Aβ1-42、Drp1含量高于治疗前(P<0.05),而IL-1β、UA、MDA、Hcy含量以及SNO-Drp1/Drp1比值低于治疗前(P<0.05)。结论DBS治疗PD患者临床疗效较好,明显改善患者的生活质量。Objective To investigate the clinical effect of deep brain stimulation(DBS)in the treatment of Parkinson′s disease(PD).Methods 32 PD patients treated in Hunan Brain Hospital from January 2016 to December 2018 were selected for the study.Guided by MRI and supplemented by electrophysiological stimulation to correct the target,PD patients were treated with DBS for the nucleus accumbens.Based on Webster and Unified Parkinsons Disease Rating Scale(UPDRS)scores before and after DBS treatment,the clinical treatment effects were evaluated.And the content of Aβ1-42,interleukin(IL)-1β,IL-6,uric acid(UA),malondialdehyde(MDA),homocysteine(Hcy),S-nitrosylated dynamin-relatedprotein 1(SNO-Drp1)and Drp1 was measured before and after DBS treatment.The ratio of SNO-Drp1/Drp1 was also measured.Results The Webster score and UPDRS score of PD patients after DBS treatment were lower than those before DBS treatment(P<0.05).The Aβ1-42 and Drp1content of PD patients after DBS treatment was higher than that before DBS treatment(P<0.05),while the content of IL-1β,UA,MDA,Hcy and the ratio of SNO-Drp1/Drp1 were lower than before treatment(P<0.05).Conclusions DBS has confirmed a good clinical effect in the treatment of PD patients and significantly improved the quality of life of patients.

关 键 词：电刺激疗法 脑深部电刺激 帕金森病 

分 类 号：R742.5[医药卫生—神经病学与精神病学]