原发单侧症状帕金森病双侧壳核磁共振波谱研究  

Magnetic resonance spectroscopy study on putamens of idiopathic Parkinson's disease with unilateral symptoms

作　　者：郑旭宁[1] 朱雄超[1] 阮凌翔[2] 张玲菊[1] 柳扬[1] 商德胜[2] 丁德云[3] 

机构地区：[1]浙江大学医学院附属第一医院神经科,杭州310003 [2]浙江大学医学院附属第一医院磁共振室,杭州310003 [3]浙江大学医学院附属第二医院神经科,杭州310003

出　　处：《中华神经科杂志》2004年第1期37-40,共4页Chinese Journal of Neurology

基　　金：浙江省医药卫生科学研究基金资助项目(2 0 0 2ZC0 0 4)

摘　　要：目的　研究帕金森病 (PD)壳核磁共振波谱 (MRS)的改变情况 ,探索PD早期诊断的线索。方法　原发单侧症状PD患者 2 5例为PD组 ,健康人 2 5名为对照组。两组分别予以双侧壳核MRS检查 ,计算乙酰天门冬氨酸 (NAA) 肌酸 (Cr) 胆碱 (Cho)浓度。结果　原发单侧症状PD组患者其症状的对侧壳核NAA/Cho +Cr的比值较同侧和健康对照组明显下降 (分别为 0 8± 0 2 ,0 9± 0 3,1 1± 0 3;t =2 4 75 ,P <0 0 5和t=5 114 ,P <0 0 0 1)。对照组双侧壳核NAA/Cho +Cr的比值之间差异无显著意义 (分别为 1 1± 0 3,1 1± 0 3;t =0 371,P >0 0 5 )。单侧症状PD患者其症状的同侧壳核NAA/Cho +Cr的比值与对照组比较差异也有显著意义 (分别为 0 9± 0 3,1 1±0 3;t=2 2 83,P <0 0 5 )。结论　单侧症状PD其症状的对侧壳核早期就可能存在神经元的缺失或神经胶质的增生 ,提示壳核磁共振波谱分析可作为PD早期或亚临床诊断的线索之一。Objective To investigate the magnetic resonance spectrum changes on putamens in early stage of Parkinson disease. Methods Twenty-five patients with idiopathic Parkinson disease with unilateral symptoms (PD) and 25 healthy volunteers were enrolled in this study. Magnetic resonance spectroscopy (MRS) was taken on putamens in each case, and then the concentrations of N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were calculated. Results Ratio of NAA/(Cho+Cr) was significantly lower in contralateral putamen of symptoms than in that of the homolateral side in the patient ( P <0.05) and either side of the healthy ( P <0.001). And there was no significant difference between the two sides in the healthy volunteers ( P >0.05). The ratio of NAA/(Cho+Cr) on the homolateral side of the patient was also lower than that of the healthy ( P <0.05). Conclusions There might be neuron degeneration and/or glial cell proliferation during the early stage of idiopathic Parkinson disease with unilateral symptom. This experiment suggests that putamen MRS should be a reliable detection method for Parkinoson disease in the early and sub-clinical stage.

关 键 词：帕金森病 双侧壳核 磁共振波谱 天冬氨酸 肌酸 胆碱 PD MRS 

分 类 号：R742.5[医药卫生—神经病学与精神病学]