帕金森病患者经颅脑实质超声所见与临床评价

Findings and clinical evaluation in patients of Parkinson's disease by Transcranial sonography

目的探讨经颅脑实质超声中发现的中脑黑质高回声与帕金森病（PD）的关系。方法连续入选2010~2013年中日友好医院门诊和住院诊断的123例PD患者及78例健康对照者,行经颅脑实质超声检查,测量黑质区域强度Ⅲ级的信号面积、第三脑室宽度及基底节区有无异常信号。并对123例PD患者进行统一帕金森病评定量表（UPDRS）评分、Hoehn＆Yahr分级。最后分析黑质高回声面积与UPDRS评分、Hoehn＆Yahr分级的相关性。结果最后入组89例PD患者及60例健康对照者。89例PD患者中,81例患者黑质高回声面积≥0.2 cm2;60例健康志愿者中,5例黑质高回声面积≥0.2 cm2。PD患者组的黑质高回声面积与健康对照组有明显差异。Pearson相关性分析发现黑质高回声面积的大小与患者发病年龄及病程长短无关系;较大侧黑质高回声与UPDRS评分的总分、第Ⅲ部分及Hoehn＆Yahr分级有明显相关性。黑质高回声面积在临床症状（UPDRSⅢ）较重的对侧较大。结论我国PD患者中脑黑质高回声是PD的一个特征性标记,其面积大小与PD患者运动症状的严重程度呈正相关,临床上可将经颅脑实质超声作为PD患者诊断的工具之一。

Objective To investigate the correlation between SN ＋ and Parkinson＇s disease by transcranial sonography. Method All 123 patients with Parkinson＇s disease who were admitted to Departement of Neurology,China-Japan Friendship Hospital,Beijing,during 2010-2013 and 78 normal controls were studied. All of them were given transcranial sonography test,the assessment of Unified Parkinson＇s Disease Rating Scale（ UPDRS） and Hoehn Yahr grading. Results Finally,89 PD patients and 60 healthy controls were included in the study. In all 89 PD patients,81 cases were found the sizes of substantia nigra hyperechogenicity ≥0. 2cm2,while 5 cases were found ≥0. 2 cm2 in all 60 normal controls.The size of substantia nigra hyperechogenicity had significant difference between PD patients and normal controls. By Pearson correlation analysis,we found the size of substantia nigra hyperechogenicity had no correlation with the onset age and the duration of PD,but the size of hyperechogenicity on the larger side had visible correlations with the total score of UPDRS,the score of Part Ⅲ of UPDRS and Hoehn Yahr grading. The size of hyperechogenicity was much bigger in the contralateral side in which side patients had much higher scores of part III of UPDRS. Conclusions Substantia Nigra hyperechogenicity is also an important mark of PD patients in China,whose size was related with the severity of clinical symptoms of PD patients. We can use transcranial sonography as a tool to help making the diagnosis of PD in clinical work.