经颅多普勒超声对血管性帕金森病和原发性帕金森病的鉴别诊断价值  

The Value of Transcranial Doppler Ultrasound in the Differential Diagnosis of Vascular Parkinson's Disease and Primary Parkinson's Disease

作　　者：李函芮 秦丽薇 LI Han-rui;QIN Li-wei(Department of Ultrasound,Jiamusi Tumor Hospital,Jiamusi 154002,Heilongjiang,China;Department of Ultrasound,the First Affiliated Hospital of Jiamusi University,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市肿瘤医院超声科,黑龙江佳木斯154002 [2]佳木斯大学附属第一医院超声科,黑龙江佳木斯154002

出　　处：《医学信息》2023年第5期143-146,共4页Journal of Medical Information

基　　金：黑龙江省教育厅课题(编号:2019-KYYWF-1358)。

摘　　要：目的研究经颅多普勒超声对血管性帕金森病和原发性帕金森病的鉴别诊断价值。方法选取2020年1月-2022年2月在佳木斯市肿瘤医院诊治的38例原发性帕金森病患者(观察组)和38例血管性帕金森病患者(对照组)为研究对象。所有患者均进行经颅多普勒超声检查,观察两组患者[大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)、基底动脉(BA)和颅外双侧椎动脉(VA)]血管异常率、两侧大脑中动脉收缩期血流速度(Vs)、舒张期末血流速度(Vd)、平均血流速度(Vm)和脉动指数(PI)、超声征象特点(脑萎缩、皮层下白质病变、脑叶损害、脑干损害、小脑损害以及基底节区)、诊断敏感度和特异度。结果观察组ACA、MCA、PCA、BA、VA血管异常率均低于对照组(P<0.05);观察组两侧大脑中动脉Vs、Vm均大于对照组,PI均小于对照组(P<0.05),Vd与对照组比较,差异无统计学意义(P>0.05);观察组脑萎缩、皮层下白质病变、脑叶损害、脑干损害、小脑损害以及基底节区病变发生率均低于对照组(P<0.05);观察组诊断敏感度、阳性预测值低于对照组(P<0.05),特异度、阴性预测值与对照组比较,差异无统计学意义(P>0.05)。结论经颅多普勒超声可发现血管性帕金森病和原发性帕金森病患者均存在脑部血流动力学改变,血管性帕金森病血管异常率相对较高,且超声征象多合并脑萎缩、皮层下白质病变、脑叶损害、脑干损害、小脑损害以及基底节区病变。经颅多普勒超声诊断血管性帕金森病敏感度相对高于原发性帕金森病,有助于两种疾病的鉴别诊断。Objective To study the value of transcranial Doppler ultrasound in the differential diagnosis of vascular Parkinson's disease and primary Parkinson's disease.Methods From January 2020 to February 2022,38 patients with primary Parkinson's disease(observation group)and 38 patients with vascular Parkinson's disease(control group)were selected as the research objects.All patients were examined by transcranial Doppler ultrasound.The vascular abnormality rate[anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and extracranial bilateral vertebral artery(VA)],systolic blood flow velocity(Vs),end diastolic blood flow velocity(Vd),mean blood flow velocity(Vm)and pulsation index(PI)of bilateral middle cerebral arteries,ultrasonic signs(brain atrophy,subcortical white matter lesions,lobe damage,brainstem damage,cerebellum damage and basal ganglia),diagnostic sensitivity and specificity of the two groups were observed.Results The abnormal rates of ACA,MCA,PCA,BA and VA in the observation group were lower than those in the control group(P<0.05).The Vs and Vm of the middle cerebral artery on both sides of the observation group were higher than those of the control group,and the PI was lower than that of the control group(P<0.05),and the Vd was compared with the control group,the difference was not statistically significant(P>0.05).The incidence of brain atrophy,subcortical white matter lesions,lobar damage,brainstem damage,cerebellar damage and basal ganglia lesions in the observation group were lower than those in the control group(P<0.05).The diagnostic sensitivity and positive predictive value of the observation group were lower than those of the control group(P<0.05),and the specificity and negative predictive value were compared with the control group,the difference was not statistically significant(P>0.05).Conclusion Transcranial Doppler ultrasound can find that there are cerebral hemodynamic changes in patients with vascular Parkinson's disease and primary Parkinson

关 键 词：经颅多普勒超声 血管性帕金森病 原发性帕金森病 鉴别诊断 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]