质子磁共振波谱在帕金森病诊治中应用价值的研究

Study on application value of hydrogen proton magnetic resonance spectroscopy in diagnosing and treating Parkinson's disease

目的评价质子磁共振波谱在帕金森病(PD)诊治中的应用价值。方法选择临床确诊的帕金森患者32例(PD组)、年龄性别匹配的健康成人15例(对照组)。所有研究对象均以双侧豆状核为感兴趣区行单体素1H-MRS检查并计算N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)和N-乙酰天门冬氨酸/胆碱(NAA/Cho)的值。结果 PD组症状不对称患者病轻侧豆状核NAA/Cr值较病重侧及对照组显著减少,CHO/Cr、NAA/CHO双侧比较差异无统计学意义;对照组豆状核左右侧NAA/Cr、CHO/Cr、NAA/CHO值比较差异无统计学意义;PD组病重侧NAA/Cr及双侧CHO/Cr、NAA/CHO值与正常对照组比较差异无统计学意义。PD组服用多巴胺类药物患者豆状核NAA/Cr、CHO/Cr、NAA/CHO值与首次诊断未治疗患者比较差异无统计学意义。结论1H-MRS可无创检测帕金森病患者豆状核代谢物改变,协助诊断帕金森病,其是否可用于评估药物治疗效果有待进一步研究。

Objective To investigate the application value of hydrogen proton magnetic resonance spectroscopy （1H-MRS） in diagnosing and treating Parkinson＇s disease（PD）. Methods Thirty-two patients with Parkinson＇s disease and 15 age-and gender-matched controls were included in this study. All subjects were inspected by the single-voxel 1H-MRS in the bilateral lenticular nucleus. Equipment automatically identified and calculated N-acetylaspartate/creatine （NAA/Cr）, choline/ereatine （Cho/Cr） and N-acety｜aspartate/choline （NAA/Cho） . Results NAA/Cr in the mild side of PD patients were significantly less than those of sick side of PD patients and both sides of the control, no significant difference were detected in CHO/Cr or NAA/CHO between them. Also, there was no significant difference in NAA/Cr, Cho/Cr, or NAA/Cho between the two sides of the control or between the sick side of PD patients and the controls or between PD patients treated with dopamine and the fist diagnosed and untreated. Conclusion J H-MRS can noninvasively detect metabelites changes of lentieular nucleus of PD patients, thus helping to diagnose the disease. But whether or not it can be used to valuate the drug efficacy is uncertain.