帕金森病患者脑部葡萄糖代谢特征分析

Characteristics of cerebral glucose metabolism in Parkinson 's disease

目的 探讨帕金森病（PD）患者脑部葡萄糖代谢特征。方法 选取2014年6月~2016年1月我院诊治的18例早期PD组（H＆YⅠ~Ⅱ级）、16例中晚期PD组（H＆YⅢ~Ⅴ级）患者和18例年龄匹配的健康对照组行静息状态下18F-FDG PET脑显像,采用统计参数图（SPM）分析法进行数据分析,比较各组脑葡萄糖代谢,获得患者脑部葡萄糖代谢变化特点。结果 与健康对照组比较,早期PD患者的双侧豆状核、丘脑及小脑葡萄糖代谢增高,差异有统计学意义（P〈0.05）;中晚期上述代谢增高区域进一步扩大,并出现双侧枕叶葡萄糖代谢减低,差异有统计学意义（P〈0.05）。结论 PD患者存在双侧豆状核、丘脑及小脑葡萄糖代谢增高及双侧枕叶葡萄糖代谢减低的异常代谢模式,且与PD病情相关,该变化特征可能有助于帕金森病的诊断和鉴别诊断。

Objective To investigate abnormal cerebral glucose metabolism characteristics in parkinson＇s disease（PD）.Methods 18 patients with early PD（HY Ⅰ-Ⅱ）,16 patients with advanced PD（HY Ⅲ-Ⅴ）and 18 healthy controls were enrolled to perform resting-state brain18F-fluorodeoxyglucose（18F-FDG） positron emission tomography（PET） imaging from June 2014 to January 2016. Statistical parametric mapping（SPM） was used to get the characteristics of cerebral glucose metabolism in patients. Results Compared with the control, hypermetabolism was observed in bilateral lentiform nucleus, thalamus and cerebellum in patients with early PD, the difference was significant（P0.05）.In advanced PD,the degree and scope of hypermetabolism increased in bilateral lentiform nucleus, thalamus and cerebellum.Additionally,hypometabolism was found in bilateral occipital lobule, the difference was significant（P0.05）. Conclusion There is a metabolic characteristics in PD patients with hypermetabolism in lentiform nucleus, thalamus and cerebellum, and hypometabolism in occipital lobule. The characteristics might be consistent with the severity of PD. These features could help with the diagnosis and differential diagnosis in PD.