磁共振引导的聚焦超声单侧苍白球丘脑束消融治疗僵直迟缓型帕金森病的安全性和有效性研究  

Safety and efficacy of mr-guided focused ultrasound unilateral pallidothalamic tractotomy for akinetic-rigid Parkinson’s disease

作　　者：曾梓敬 周珈右 尹春宇 林家骥 刘云默 陆皓璇 张德康 张剑宁 娄昕[4] 李雪梅[3] 潘隆盛[2] ZENG Zijing;ZHOU Jiayou;YIN Chunyu;LIN Jiaji;LIU Yunmo;LU Haoxuan;ZHANG Dekang;ZHANG Jianning;LOU Xin;Li Xuemei;PAN Longsheng(Chinese PLA Medical School,Beijing 100853,China;Department of Neurosurgery,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Cadres’Outpatient,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Radiology,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Neurology,Second Affiliated Hospital of Air Force Medical University,Xi’an,Shaanxi 710038,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第一医学中心神经外科,北京100853 [3]解放军总医院第一医学中心门诊部干部诊疗科,北京100853 [4]解放军总医院第一医学中心放射诊断科,北京100853 [5]空军军医大学第二附属医院神经内科,陕西西安710038

出　　处：《中华神经外科疾病研究杂志》2024年第6期22-27,共6页Chinese Journal of Neurosurgical Disease Research

基　　金：中国人民解放军军队保健专项课题面上项目(22BJZ24)。

摘　　要：目的探讨聚焦超声单侧苍白球丘脑束(pallidothalamic tract,PTT)消融治疗僵直迟缓型帕金森病(akinetic-rigid Parkinson’s disease,ARPD)的安全性和有效性。方法14例ARPD患者纳入研究,并接受单侧PTT消融术。采集术前、术后1个月和3个月帕金森病统一评定量表(unified Parkinson's disease rating scale,UPDRS)评分和影像学数据。非参数检验进行定量分析,皮尔逊相关系数初步探索影响疗效的因素。结果14例ARPD患者术后1、3个月的UPDRS评分较基线下降(P<0.001),术后配合药物可使评分进一步下降(P<0.001),其总改善率与时间、美多芭冲击试验改善率、Hoehn-Yahr分期和不良事件总数相关(P<0.05)。手术不良事件较轻微。结论聚焦超声单侧PTT消融治疗ARPD安全有效。Objective To investigate the safety and efficacy of MR-guided focused ultrasound(MRgFUS)unilateral pallidothalamic tractotomy(PTT)for akinetic-rigid Parkinson’s disease(ARPD).Methods Fourteen patients with ARPD were included in the study and underwent unilateral tractotomy.Unified Parkinson's Disease Rating Scale(UPDRS)scores and imaging data were collected at baseline and at 1,3 months after tractotomy.The nonparametric tests were used for quantitative analysis,and correlation analysis was used for screening the factors affecting the efficacy.Results The UPDRS score of the 14 patients with ARPD decreased from baseline at 1 and 3 months after tractotomy(P<0.001),and the score was further decreased in on-medication state after tractotomy(P<0.001).Total improvement rate was related to time,improvement rate of levodopa challenge test,Hoehn-Yahr stage and number of adverse events(P<0.05).Adverse events were minor.Conclusions MRgFUS unilateral PTT for ARPD is safe and effective.

关 键 词：磁共振引导聚焦超声 僵直迟缓型帕金森病 苍白球丘脑束 疗效 安全性 

分 类 号：R742.5[医药卫生—神经病学与精神病学]