基于fMRI评价胰高血糖素样肽-1联合奥匹卡朋、左旋多巴治疗帕金森病的临床价值  

Evaluation of the Clinical Value of Glucagon-like Peptide 1 Combined with Opicapone and Levodopa in Treating Parkinson's Disease Based on fMRI

作　　者：白管兵 潘波 潘娜 BAI Guan-bing;PAN Bo;PAN Na(Department of Neurology,Air Force Medical University Air Force 986 Hospital,Xi'an 710054,Shaanxi Province,China)

机构地区：[1]空军军医大学空军第九八六医院神经内科,陕西西安710054

出　　处：《中国CT和MRI杂志》2024年第11期20-22,共3页Chinese Journal of CT and MRI

基　　金：解放军空军后勤科研基金项目(CKJ17J019)。

摘　　要：目的研究基于功能核共振成像(functional magnetic resonance imaging,fMRI)评价胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)皮下注射联合奥匹卡朋、左旋多巴对帕金森病(Parkinson's disease,PD)患者中的应用价值。方法选取2020年2月至2023年2月期间在我院就治的198例PD患者,应用随机分组法分为观察组和对照组,各99例。对照组采用口服奥匹卡朋、左旋多巴治疗,观察组在此基础上采用皮下注射GLP-1治疗。治疗6个月后,比较2组患者的fMRI表现、临床症状改善情况、表皮生长因子(epidermal growth factor,EGF)、胶质原纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、和不良反应发生情况。结果治疗后,观察组10m折返运动试验时间短于对照组,统一帕金森病评定量表第3部分(unified Parkinson's disease rating scale,UPDRSⅢ)评分、帕金森病非运动症状量表(non-motor Symptoms Scale,NMSS)评分明显低于对照组(P<0.05);治疗后,观察组GFAP水平明显低于对照组(P<0.05),EGF水平高于对照组(P<0.05);经Post-Hoc检验显示,与对照组相比,观察组组患者右侧额中回、左侧额中回、右侧后扣带回ALFF值降低,右侧小脑后叶、左侧楔状叶ALFF值升高(P<0.05);治疗期间,2组患者不良反应发生不具一般可比性(P>0.05)。结论GLP-1皮下注射联合奥匹卡朋+左旋多巴治疗PD患者安全性良好,能够显著改善患者运动功能、非运动症状,有效调节血液生物标志物EGF和GFAP,fMRI结果也显示可能通过改善脑区功能来改善其临床症状。Objective To study the application value of subcutaneous injection of glucagon-like peptide-1(GLP-1)combined with opicapone and levodopa in patients with Parkinson's disease(PD)based on functional magnetic resonance imaging(fMRI).Methods A total of 198 patients with PD treated in the hospital from February 2020 to February 2023 were randomly divided into the observation group and the control group with 99 patients in each group.The control group was treated with oral opicapone and levodopa,while the observation group was treated with subcutaneous injection of GLP-1 on this basis.After 6 months of treatment,the improvement of clinical symptoms,the influence on epidermal growth factor(EGF),glial fibrillary acidic protein(GFAP),fMRI findings and adverse reactions were compared between groups.Results After treatment,the 10m shuttle walk test time of the observation group was shorter than that of the control group.The Unified Parkinson's Disease Rating Scale(UPDRS III)score and Non-motor Symptoms Scale(NMSS)scores were significantly lower than those of the control group(P<0.05).After treatment,GFAP level in the observation group was significantly lower than that in the control group(P<0.05),and EGF level was higher than that in the control group(P<0.05).Post-Hoc test found that ALFF values of the right middle frontal gyrus,left middle frontal gyrus and right posterior cingulate in the observation group were higher,and the ALFF values of the right posterior cerebellar lobe and left cuneiform lobe were lower than those in the control group(P<0.05).The incidence rates of adverse reactions in the two groups were close(P>0.05).Conclusion Subcutaneous injection of GLP-1 combined with opicapone and levodopa is safe in treating PD.The combined treatment can significantly improve the patients’motor function and non-motor symptoms,effectively regulate EGF and GFAP.fMRI results indicate that clinical symptoms may be alleviated through improving brain function.

关 键 词：帕金森 胰高血糖素样肽-1 皮下注射 奥匹卡朋 左旋多巴 生物标志物 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]