进行性核上性麻痹患者脑部影像学特点及其与临床症状的相关性研究  

Study on the imaging characteristics of the brain in patients with progressive supranuclear palsy and its correlation with clinical symptoms

作　　者：贾培飞 纪勇[2] Jia Peifei;Ji Yong(Department of Neurology,the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou 014030,China;School of Neurology and Clinical Rehabilitation,Tianjin Medical University,Huanhu Hospital,Tianjin 300070,China)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院神经内科,014030 [2]天津市环湖医院天津医科大学神经内外科及神经康复临床学院,300070

出　　处：《神经疾病与精神卫生》2024年第12期884-889,共6页Journal of Neuroscience and Mental Health

基　　金：天津市卫生健康科技项目(TJWJ2023QN060)。

摘　　要：目的分析进行性核上性麻痹(PSP)患者影像学特征及其与临床症状的相关性。方法选取2017年10月—2021年10月于天津环湖医院诊疗的132例PSP患者为PSP组,同期、同院的132名健康体检者为对照组,收集所有受试者一般资料、临床表现、神经科体检情况、头颅磁共振成像(MRI)及正电子发射断层成像(PET)等神经影像学资料进行分析。结果PSP组与对照组在性别、年龄、文化程度比较,差异无统计学意义(均P>0.05);蜂鸟症发生率(58.33%比0%)比较,差异有统计学意义(P<0.001);52例完成氟-18-氟代脱氧葡萄糖(18F-FDG)PET检查,分析显示PSP患者在额叶、尾状核、丘脑及中脑葡萄糖代谢率低;PSP患者垂直凝视麻痹比非垂直凝视麻痹前扣带回区葡萄糖代谢率下降更明显,痴呆组比非痴呆组在左颞叶、岛叶、前扣带回脑区葡萄糖代谢率下降更明显,差异均有统计学意义(均P<0.05)。结论影像学有助于PSP早期诊断及鉴别,临床症状与特定脑区葡萄糖代谢相关。Objective To analyze the imaging characteristics of progressive supranuclear palsy(PSP),and its correlation with clinical symptoms.Methods A total of 132 PSP patients treated at Tianjin Huanhu Hospital from October 2017 to October 2021 were selected as the PSP group,and 132 healthy individuals who underwent physical examinations at the same hospital during the same period were selected as the control group.All patients data were collected and analyzed,including general information,clinical manifestations,neurological examination results,cranial MRI,PET and other neuroimaging data.Results There was no significant difference between PSP group and healthy control group in gender,age and education level(all P>0.05),but there was significant difference in the incidence of hummingbird disease(58.33%vs 0%).52 patients completed 18F-FDG PET examination,and the analysis showed that the metabolic rate of glucose in the frontal lobe,caudate nucleus,thalamus and midbrain of PSP patients was low;In patients with PSP,the glucose metabolic rate in the anterior cingulate cortex of vertical gaze palsy(VGP)decreased more significantly than that of not-VGP,and the glucose metabolic rate in the left temporal lobe,insular lobe,and anterior cingulate cortex of dementia group decreased more significantly than that of non dementia group(all P<0.05).Conclusions Imaging is helpful for early diagnosis and differentiation of PSP,and clinical symptoms are related to glucose metabolism in specific brain regions.

关 键 词：核上麻痹 进行性 影像学特征 临床症状 相关性 

分 类 号：R741[医药卫生—神经病学与精神病学]