小剂量左旋多巴治疗对早期帕金森病患者壳核代谢的影响

Influence of low-dose levodopa therapy on metabolism of putamen in patients with early-stage Parkinson disease

目的探讨小剂量左旋多巴治疗对早期帕金森病(PD)患者壳核代谢的影响。方法对20例单侧症状的PD患者(PD组,Hoehn-Yahr 1级)应用小剂量左旋多巴治疗,分别于治疗前后进行壳核的氢质子磁共振波谱(1H-MRS)检测,并与20名正常对照者(正常对照组)比较。结果 PD组治疗前症状对侧壳核N-乙酰天门冬氨酸(NAA)/磷酸肌酸(Cr)比值低于症状侧及正常对照组(均P<0.01),NAA/胆碱(Cho)比值低于正常对照组(P<0.05);PD组治疗后症状对侧壳核NAA/Cr比值显著高于治疗前(P<0.01)。结论小剂量左旋多巴治疗可逆转早期PD患者病损侧壳核神经元的低代谢状态。

Objective To explore the influence of low-dose levodopa therapy on metabolism of putamen in patients with early-stage Parkinson disease （PD）. Methods 20 PD patients with unilateral symptoms （ PD group, Hoehn-Yahr stage I ） received low-dose levodopa therapy. The examination of I H-MRS focused on putamens were carried out in the PD group before and after therapy respectively; and the results were compared with 20 normal controls （NC group）. Results In PD group before the therapy, the ratio of N-acetyl-l-aspartate （NAA）/ereatine （Cr） in the putamens of symptom＇s opposite side was significantly lower than those in the symptom＇s side and NC group （ all P 〈 0. 01 ）. The ratio of NAA/Choline （Cho） was significantly lower than NC group （ P 〈 0. 05 ）. After therapy, the ratio of NAA/Cr in the putamens of symptom＇s opposite side was significantly higher than before therapy （ P 〈 0. 01 ）. Conclusion The therapy＇ of low-dose levodopa can reverse the low metabolism of impaired putamens in patients with early-stage PD.