[^(123)I]-IBZM SPECT显像检测帕金森病患者脑多巴胺D_2受体

Determination of brain dopamine D 2 receptors using [ 123 I]-iodobenzamide(IBZM) SPECT in patients with Parkinson's disease

目的：观察帕金森病（ＰＤ）患者脑多巴胺Ｄ２受体的变化。方法：［１２３Ｉ］－（Ｓ）－（一）－３－碘－２－羟基－６－甲氧基－Ｎ－［（１－乙基－２－吡咯烷基）］苯酰胺（ｉｏｄｏｂｅｎｚａｍｉｄｅ，ＩＢＺＭ）为放射配体，对１３例未接受左旋多巴治疗的原发性ＰＤ（ＩＰＤ－Ａ组）、１８例接受左旋多巴治疗的原发性ＰＤ（ＩＰＤ－Ｂ组）、８例继发性帕金森氏综合征（ＳＰＳ组）和７例正常对照者进行了［１２３Ｉ］－ＩＢＺＭ脑多巴胺Ｄ２受体ＳＰＥＣＴ显像和半定量分析。结果：正常对照组［１２３Ｉ］－ＩＢＺＭ静注后１２０ｍｉｎ在基底节中［１２３Ｉ］－ＩＢＺＭ放射性聚集最高，脑内其它部位如额叶、枕叶和小脑内［１２３Ｉ］－ＩＢＺＭ放射性低，基底节／小脑（ＢＧ／ＣＢ）放射性比值随年龄增长而显著下降（ｒ＝－０．７５，Ｐ＝０．０５）。ＩＰＤ－Ａ组的ＢＧ／ＣＢ比值与正常对照组比较无显著差异（Ｐ＞０．０５），ＩＰＤ－Ｂ组的ＢＧ／ＣＢ比值明显低于ＩＰＤ－Ａ组（Ｐ＜０．０５）和正常对照组（Ｐ＜０．０１）。ＳＰＳ组的ＢＧ／ＣＢ比值低于ＩＰＤ－Ａ组和正常对照组（Ｐ＜０．０５）。结论：未接受左旋多巴治疗的原发性ＰＤ患者具有高的多巴胺Ｄ２受体密度，而接受左旋多巴治?

AIM:To observe the changes of brain dopamine D 2 receptors in the basal ganglia in patients with Parkinson's disease.METHODS:Semiquantitative analysis of dopamine D 2 receptors using[ 123 I]-IBZM SPECT(single photon emission computed tomography) were performed in 31 patients with idiopathic Parkinson's disease (IPD),8 patients with secondary Parkinson's syndrome (SPS)and 7 controls.RESULTS:13 IPD patients without L-dopa-therapy(IPD-A)and the controls revealed high and specific [ 123 I]-IBZM uptake in the basal ganglia compared to the cerebellum (BG/CB).18 IPD patients with L-dopa-therapy (IPD-B) was demonstrating significantly decreased BG/CB ratio compared to controls, P<0.01 and IPD-A( P <0.05).A significant decreased GB/CB ratio is found in cases with SPS compared to controls and IPD-A( P<0.05 ). CONCLUSIONS:There was a high and specific[ 123 I]-IBZM uptake in the basal ganglia in IPD patients without L-dopa-therapy and a decreased striatal IBZM uptake in the basal gangliain IPD patients without L-dopa-therapy and a decreased striatal IBZM uptake in IPD patients with L-dopa-therapy and patients with SPS.