不同靶点下脑深部电刺激治疗帕金森的疗效对比

Comparison the efficacy of deep brain stimulation with different target points on patients of parkinson's disease

目的探讨不同靶点下脑深部电刺激治疗帕金森病(PD)的疗效。方法立体定向微电极植入丘脑底核(STN)与苍白球内侧核(GPi),术后观察PD症状的改善情况,分别计算"关"状态下和"开"状态下肢体症状改善率,分别于术前、术后1月、1年对患者进行UPDRS运动功能及日常生活评分的随访分析,并比较手术前后左旋多巴服用剂量变化情况。结果 DBS对PD症状有效率达到100%,且术后在"关"状态下较"开"状态的改善率更高,效果更明显。术后UPDRS运动功能及日常生活评分较术前显著降低,且STN-DBS术后左旋多巴用量在减轻PD症状的同时可减少术后药物使用量。结论 DBS治疗帕金森病具有显著疗效,其中尤以STN-DBS在保证疗效同时可减少药物用量。

Objective To observe curative efficacy of deep brain stimulation （DBS） treatment for Parkinson＇s disease （PD） in the different target points. Methods Stereotactic microelectrode implanted in the subthalamic nucleus （STN） and globus pallidusinterna （ Gpi）, and the improvement of symptoms in PD after operation were observed, meanwhile the improvement rate of body symptom in the ＂on＂ and ＂off＂ states were calculated respectively. UP- DRS motor function and activities of daily living scores of patients were investigated before surgery and 1 and 12 month after surgery, as well as the levodopa dose changes before and after surgery. Results It is 100% efficiency for DBS treatment of PD symptoms. Compared with the ＂open＂ state, the improvement rate of the ＂off＂ state was high- er, and the effect is more obvious. The score of motor compared with the preoperative. STN -DBS not only function and daily living reduced significantly after operation can reduce postoperative levodopa dosage but also relieve the symptoms of PD. Conclusion There is a significant effect by using DBS to treat Parkinson＇s disease, and especially, STN -DBS ensure efficacy and reduce drug dosage