帕金森病^(131)I-间碘苄胍心肌显像初步研究

^(131)I-MIBG myocardial scintigraphy in patients with Parkinson's disease

研究背景由于^(131)I-间碘苄胍(^(131)I-MIBG)可被心脏交感神经节后纤维摄取,可作为评价心脏交感神经功能的显像剂。本研究采用^(131)I-MIBG心肌显像方法评价帕金森病患者心脏交感神经功能,并初步探讨该项检查方法在帕金森病早期诊断中的作用。方法共21例帕金森病患者(早期16例、晚期5例)和9例正常对照者,采用统一帕金森病评价量表和Hoehn-Yahr分级评价病情严重程度,静脉注射^(131)I-MIBG 3 m Ci后于不同观察时间点(15 min、4 h、24 h)采集胸部前位平面像,计算^(131)I-MIBG心肌摄取率。结果 (1)与正常对照组相比,帕金森病组患者注射药物后15 min(1.67±0.38)、4 h(1.53±0.47)和24 h(1.35±0.42)^(131)I-MIBG心肌摄取率均降低(P=0.000,0.000,0.000);且随着时间的推移,^(131)I-MIBG心肌摄取率亦降低(P=0.002,0.000,0.000)。(2)与正常对照组相比,早期和晚期帕金森病组患者注射药物后15 min[(1.73±0.40)和(1.50±0.30)]、4 h[(1.58±0.51)和(1.37±0.31)]、24 h[(1.39±0.46)和(1.24±0.29)]^(131)I-MIBG心肌摄取率均降低(早期:P=0.000,0.000,0.000;晚期:P=0.000,0.000,0.000);且随着时间的推移,早期与晚期帕金森病患者^(131)I-MIBG心肌摄取率亦降低(早期:P=0.012,0.000,0.000;晚期:P=0.039,0.001,0.024)。结论帕金森病患者存在心脏交感神经功能障碍,且病情早期出现,^(131)I-MIBG心肌显像可能有助于帕金森病的早期诊断。

Background 131I-metaiodobenzylguanidine （131I-MIBG）, which can be taken by cardiac sympathetic postganglionic fibers, is an imaging agent to assess the cardiac sympathetic nerve function. The present study is to assess the cardiac sympathetic nerve function of patients with Parkinson＇s disease （PD） by 131I-MIBG myocardial scintigraphy and preliminarily explore its applications in the early diagnosis of PD. Methods Twenty-one eligible PD patients （16 early PD and 5 late PD） and 9 normal controls were enrolled in the study. Unified Parkinson＇s Disease Rating Scale （UPDRS） and Hoehn-Yahr stage were used to evaluate the severity of PD. Planar images of chest were obtained at different time points （15 min, 4 h and 24 h） after injection of 3 mCi 131I-MIBG, and then the 131I-MIBG myocardial uptake ratios were calculated. Results 1） The 131I-MIBG myocardial uptake ratios in PD group at 15 min （1.67±0.38）, 4 h （1.53±0.47） and 24 h （1.35±0.42） after injection were lower than those in the normal control group respectively （P = 0.000, 0.000, 0.000）, and the 131I-MIBG myocardial uptake ratios in the PD group reduced over time （P = 0.002, 0.000, 0.000）. 2） The 131I-MIBG myocardial uptake ratios in the early and late PD groups at 15 min [（1.73±0.40） and （1.50±0.30）], 4 h [（1.58±0.51） and （1.37±0.31）], 24 h [（1.39±0.46） and （1.24±0.29）] after injection were lower than those in the normal control group respectively （early PD： P = 0.000, 0.000, 0.000; late PD： P = 0.000, 0.000, 0.000）, and the 131I-MIBG myocardial uptake ratios in the early and late PD groups reduced over time （early PD： P = 0.012, 0.000, 0.000; late PD： P = 0.039, 0.001, 0.024）. Conclusions Cardiac sympathetic nerve damage could occur in PD patients, even at an early stage of PD. 131I-MIBG myocardial seintigraphy may help in the early diagnosis of PD.