经颅超声在帕金森病与帕金森叠加综合征鉴别诊断中的临床应用  

Clinical application of transcranial sonography in the differential diagnosis of Parkinson's disease and Parkinson's superimposed syndrome

作　　者：亓爱芹 徐海娟 张海宁 宋方禹 QI Ai-qin;XU Hai-juan;ZHANG Hai-ning(Shandong First Medical University Affiliated People's Hospital,Jinan 271199,China)

机构地区：[1]山东第一医科大学附属人民医院,271199

出　　处：《中国实用医药》2024年第5期41-45,共5页China Practical Medicine

基　　金：2020年济南市卫生健康委员会第二批科技计划项目(项目编号:2020-4-135);济南市科学技术局临床医学科技创新计划(项目编号:202019075)。

摘　　要：目的探讨经颅超声(TCS)在帕金森病(PD)与帕金森叠加综合征鉴别诊断中的价值。方法选取40例PD(早期PD 20例,晚期PD 20例)患者,40例帕金森叠加综合征[多系统萎缩P型(MSA-P)25例,进行性核上性麻痹(PSP)15例]患者,40例同期健康人,分别设为PD组、帕金森叠加综合征组、对照组;PD组分设两个亚组:早期PD组、晚期PD组,帕金森叠加综合征组分设两个亚组:MSA-P组、PSP组。所有受试者均行TCS[中脑黑质(SN)强回声、第三脑室宽度、豆状核(LN)强回声与中脑面积]检查,两两比较不同分组的差异;对比MSA-P组和PSP组、早期PD组和晚期PD组的TCS结果。结果帕金森叠加综合征组LN异常强回声比例75.0%(30/40)高于PD组的25.0%(10/40)及对照组的2.5%(1/40),组间差异均有统计学意义(P<0.05)。PD组SN异常强回声比例82.5%(33/40)高于帕金森叠加综合征组的62.5%(25/40)及对照组的7.5%(3/40),组间差异均有统计学意义(P<0.05)。帕金森叠加综合征组第三脑室宽度与中脑面积分别为(7.38±3.12)mm、(4.12±0.51)cm^(2),PD组分别为(5.54±1.86)mm、(4.42±1.42)cm^(2),对照组分别为(5.91±1.93)mm、(4.81±1.01)cm^(2),帕金森叠加综合征组第三脑室宽度宽于PD组与对照组,中脑面积小于PD组与对照组,组间差异均有统计学意义(P<0.05)。MSA-P组LN异常强回声比例为76.0%(19/25),PSP组LN异常强回声比例为73.3%(11/15),组间差异无统计学意义(P>0.05)。MSA-P组SN异常强回声比例76.0%(19/25)高于PSP组的40.0%(6/15),组间差异有统计学意义(P<0.05)。MSA-P组第三脑室宽度与中脑面积分别为(6.49±3.09)mm、(4.51±0.49)cm^(2),PSP组第三脑室宽度与中脑面积分别为(8.29±1.18)mm、(3.21±0.38)cm^(2),MSA-P组第三脑室宽度窄于PSP组,中脑面积大于PSP组,组间差异有统计学意义(P<0.05)。早期PD组LN异常强回声比例、第三脑室宽度与中脑面积与晚期PD组比较差异无显著统计学意义(P>0.05)。早期PD组SN异常强回声19例(95.0%Objective To explore the value of transcranial sonography(TCS)in the differential diagnosis of Parkinson's disease(PD)and Parkinson's superimposed syndrome.Methods 40 patients with PD were selected as PD(20 case with early PD,20 cases with late PD)group,40 patients with Parkinson's superimposed syndrome[25 patients with multiple system atrophy P type(MSA-P),15 patients with progressive suprachinuclear paralysis(PSP)]as Parkinson's superimposed syndrome group,and 40 healthy individuals as the control group.PD group was divided into two subgroups:early PD group and late PD group,and Parkinson's superimposed syndrome group was divided into two subgroups:MSA-P group and PSP group.All subjects received TCS[midbrain substantia nigra(SN)hyperechogenicity,third ventricular width,lenticular nucleus(LN)hyperechogenicity,and midbrain area were examined,and the differences between every two groups were compared;compared the TCS results between MSA-P group and PSP group,and between early PD group and late PD group.Results The proportion of abnormal hyperechogenicity of LN in Parkinson's superimposed syndrome group was 75.0%(30/40),which was higher than 25.0%(10/40)in PD group and 2.5%(1/40)in control group,and the difference between groups was statistically significant(P<0.05).The proportion of abnormal hyperechogenicity of SN in PD group was 82.5%(33/40),which was higher than 62.5%(25/40)in Parkinson's superimposed syndrome group and 7.5%(3/40)in control group,and the difference between groups was statistically significant(P<0.05).The third ventricular width and midbrain area of Parkinson's superimposed syndrome group were(7.38±3.12)mm and(4.12±0.51)cm^(2),those of PD group were(5.54±1.86)mm and(4.42±1.42)cm^(2),and those of control group were(5.91±1.93)mm and(4.81±1.01)cm^(2).The third ventricular width in Parkinson's superimposed syndrome group was wider than that in PD group and control group,and the midbrain area was smaller than that in PD group and control group.The difference was statistically significant(P<0.05

关 键 词：经颅超声 帕金森病 帕金森叠加综合征 

分 类 号：R742.5[医药卫生—神经病学与精神病学]