帕金森病~(99m)TC-TRODAT-1多巴胺转运体单光子计算机断层摄影脑显像研究

目的应用~(99m)Tc-TRODAT-1多巴胺转运体(DAT)单光子计算机断层摄影(SPECT)脑显像,研究不同运动障碍亚型帕金森病(Parkinson's diseas e,PD)纹状体生化改变。方法选择不同运动障碍亚型PD患者68例,其中震颤为主型PD患者36例(震颤PD组),姿势异常步态障碍(PIGD)为主型PD患者32例(PIGD PD组),分别行~(99m)Tc-TRODAT-1 DAT SPECT脑显像,利用感兴趣区技术计算首发症状对侧纹状体与小脑的特异性放射性比值。结果 PIGD PD组患者首发症状对侧纹状体、小脑较震颤PD组患者明显降低(1.43±0.92) vs (1.49±0.10),P0.05]。纹状体、小脑下降与PIGD评分呈负相关(r=-0.73,P0.05),而与震颤评分无明显相关性(r=-0.21,P0.05)。结论不同运动障碍亚型PD患者~(99m)Tc-TRODAT-1 DAT SPECT脑显像存在明显的异质性,PIGD为主型PD患者纹状体DAT的功能降低更明显,提示不同运动障碍亚型PD有不同的生化病理基础。

Study on the 99mTc-TRODAT-1 DAT SPECT imaging of dopamine transporter in Parkinson's disease

Objective To investigate the biochemical change of striatum by ~(99m)Tc-TRODAT-1 DAT SPECT imaging in Parkinson's disease(PD) with different subtypes of movement disorder.Methods Sixty-eight PD patients with different subgroups of movement disorder were studied by ~(99m)Tc-TRODAT-1 DAT SPECT imaging.Of them,36 tremor-dominant PD patients and 32 postural instability-gait disorder(PIGD)-dominanl PD patients were detected.Striatum-specific uptake of ~(99m)Tc-TRO DAT-1 was calculated according to the ratio of DAT uptake in striatum(ST) and cerebellum(CB).Results In the PIGD-dominant PD group,the DAT specific uptake of ~(99m)Tc-TRODAT -1 was significantly lower than that in the tremor-dominant PD group[(1.43±0.92) vs (1.49±0.10) ,P < 0.05].There was negative correlation between the ST/CB radiation ratio and the PIGD score of UPDRS (r=-0.73,P< 0.05),but no relationship between tremor score and ST/CB ratio (r =-0.21,P > 0.05).Conclusions The results indicate that there is significant difference in the striatum-specific uptake of ~(99m)Tc-TRODAT-1 between the tremor-dominant PD and PIGD-dominant PD and the decrease in the striatum-specific uptake of ~(99m)Tc-TRODAT-1 is more sinificant in the PIGD-dominant PD,suggesting that there is different biochemical pathologic basis between different movement disorder subgroups of PD.