帕金森病患者立体定向手术前后脑脊液单胺类递质含量的改变

目的　研究帕金森病 (PD)患者脑立体定向手术前后脑脊液 (CSF)中单胺类递质含量的变化。方法测定 2 6例原发性PD患者 (PD组 )脑立体定向术前、后CSF中多巴胺 (DA)、5 羟色胺 (5 HT)、去甲肾上腺素 (NE)及其代谢产物高香草酸 (HVA)、5 羟吲哚乙酸 (5 HIAA)、3 甲氧基 4羟基苯乙二醇 (MHPG)的含量 ,另外测定 2 5例外科疾病腰麻手术患者 (对照组 )CSF中HVA、5 HIAA、MHPG含量。结果　PD组CSF中HVA、5 HIAA、MHPG含量明显低于对照组 (P <0 0 0 1、P <0 0 5、P <0 0 0 1) ;手术后组的CSF中DA、HVA ,、5 HT、5 HIAA、NE、MHPG含量明显高于手术前组 (其中DA、HVA、5 HT、5 HIAA和NE均P <0 0 0 1;MHPGP <0 0 5 )。结论　PD患者CSF单胺类神经递质代谢产物含量明显降低 ,脑立体定向术可提高PD患者脑部单胺类神经递质及其代谢产物的含量 ,其发生机制可能与DA能神经元的保护作用有关

Change of monoamine neurotransmitter content in cerebrospinal fluid in patients with Parkinson's disease before and after stereotactic operation

Objective To study the change of monoamine content in cerebrospinal fluid(CSF) in patients with Parkinson's disease(PD) before and after stereotactic operation.Methods Dopamine(DA),5 hydroxytryptamine(5 HT),norepinephrine(NE) and homovanilic acid(HVA),5 hydroxyindoleacetic acid(5 HIAA),3 methoxy 4 hydroxyphenylglycol(MHPG) levels of CSF in 26 PD patients befor and after the operation and HVA,5 HIAA and MHPG levels in CSF of 25 normal controls were measured.Results CSF levels of HVA,5 HIAA and MHPG in PD group were significantly lower than those in control group( P < 0 001, P < 0 05, P < 0 001).CSF levels of DA,5 HT,NE,HVA,5 HIAA(all P < 0 001) and MHPG( P < 0 05) in postoperation group were significantly higher than those in preoperation group.Conclusion The CSF levels of monoamine metabolites in patients with PD are significant decrease.stereotactic functional neurosergery for PD may increase levels of monoamine neurotransmitter.It is possible associated with protecting dopaminergic neurons.