多模态MRI评价胞磷胆碱联合卡左双多巴控释片治疗老年帕金森病的疗效  

Curative effect of citicoline combined with carbidopa/levodopa controlled-release tablet in elderly patients with Parkinson’s disease evaluated by multimodal MRI

作　　者：包丽岩 孔伟[1] 郭清[1] BAO Liyan;KONG Wei;GUO Qing(Jixi Hospital of Traditional Chinese Medicine,Jixi 158100,China)

机构地区：[1]鸡西市中医医院,黑龙江鸡西158100

出　　处：《中国实用神经疾病杂志》2024年第12期1522-1527,共6页Chinese Journal of Practical Nervous Diseases

基　　金：中国管理科学研究院教育科学研究所科教创新研究重点课题(编号:KJCX22178)。

摘　　要：目的采用多模态MRI评价胞磷胆碱联合卡左双多巴控释片治疗老年帕金森病(PD)患者的疗效。方法选取2020-01—2022-12鸡西市中医医院神经内科收治的130例老年PD患者,采用随机数字表法分为A组和B组各65例。B组予以卡左双多巴控释片治疗,A组在B组基础上联合胞磷胆碱治疗,均持续治疗12周。治疗前后接受多模态MRI检查,包括磁共振弥散张量成像(DTI)、氢质子磁共振波谱成像技术(1H-MRS)和扩散张量成像(DKI)3b序列。比较2组治疗前后的蒙特利尔认知评估量表(MoCA)评分、简易精神状态量表(MMSE)评分、帕金森综合评分量表(UPDRS)评分及多模态MRI参数值。采用Pearson相关性分析多模态MRI参数与MMSE、MoCA和UPDRS评分的关系。结果治疗后,A组患者MMSE评分、MoCA评分均高于B组,UPDRS评分低于B组(P<0.05),DKI-MK值、DKI-MD值、DTI-FA值、DTI-ADC值和MI/Cr值均低于B组,NAA/Cr值高于B组(P<0.05)。Pearson相关性分析显示老年PD患者DKI-MK值、DTI-FA值、DTI-ADC值、MI/Cr值与MMSE评分、MoCA评分呈正相关,与UPDRS评分呈负相关(P<0.05)。结论胞磷胆碱联合卡左双多巴控释片可有效提高老年PD患者的临床疗效,多模态MRI检查可提供更为全面、准确和有效的客观影像学评估指标。Objective To analyze the curative effect of citicoline combined with carbidopa/levodopa controlled-release tablet in the treatment of elderly patients with Parkinson’s disease(PD)evaluated by multimodal MRI.Methods A total of 130 elderly patients with PD admitted to Neurology Department of Jixi Hospital of Traditional Chinese Medicine were enrolled between January 2020 and December 2022.According to the random number table method,they were divided into group A and group B,65 cases in each group.The group B was treated with carbidopa/levodopa controlled-release tablets,while group A was additionally treated with citicoline.All the patients were treated for 12 weeks.All the patients underwent multimodal MRI examinations before and after treatment,including diffusion tensor imaging(DTI),hydrogen proton magnetic resonance spectroscopy(1 H-MRS)and diffusion tensor imaging(DKI)3b sequence.The scores of Montreal cognitive assessment(MoCA),mini-mental state examination(MMSE)and unified Parkinson disease rating scale(UPDRS),the levels of dopamine(DA),norepinephrine(NE)and 5-hydroxytryptamine(5-HT),and multimodal MRI parameters in the two groups were compared before and after treatment.The relationship between multimodal MRI parameters and MMSE,MoCA and UPDRS scores was analyzed by Pearson correlation analysis.Results After treatment,MMSE and MoCA scores in group A were higher than those in group B,and UPDRS score was lower than that in group B(P<0.05).The levels of serum DA,NE and 5-HT in group A were higher than those in group B(P<0.05).DKI-MK,DKI-MD,DTI-FA,DTI-ADC and MI/Cr in group A were lower than those in group B,while NAA/Cr was greater than that in group B(P<0.05).Pearson correlation analysis showed that DKI-MK,DTI-FA,DTI-ADC and MI/Cr were positively correlated with MMSE and MoCA scores,while negatively correlated with UPDRS score(P<0.05).Conclusion Citicoline combined with carbidopa/levodopa controlled-release tablet can effectively improve clinical curative effect in elderly patients with PD.Multimodal MRI ca

关 键 词：帕金森病 老年 胞磷胆碱 卡左双多巴控释片 多模态MRI 

分 类 号：R742.5[医药卫生—神经病学与精神病学]