CAJ | 학술논문

目的研究帕金森病(PD)患者的多巴胺转运体代谢与多巴胺能反应性是否具有相关性.方法选择13例Hohen-Yabr Ⅱ期PD患者,分别应用急性阶梯式左旋多巴/苄丝肼(50.0/12.5、100.0/25.0、150.0/37.5 mg)试验评价患者的急性多巴胺能反应性,应用甲酯基托品烷衍生物(11C-CFT)PET研究基底节区的多巴胺转运体代谢变化.分析服用左旋多巴后PD患者的统-PD评分量表运动分量表(UPDRS Ⅲ)评分改善率与基底节区多巴胺转运体示踪剂11C-CFT摄取强度的相关性.结果 13例PD患者首发症状肢体时侧的壳核后部11C-CFT摄取信号缺损,11例患者首发症状肢体同侧的壳核后部11C-CFT摄取信号部分缺损.首发症状肢体对侧的壳核后部11C-CFT摄取信号强度低于首发症状同侧,差异有统计学意义(P＜0.01).PD患者在左旋多巴/苄丝肼100.0/25.0 mg和150.0/37.5 mg剂量水平的UPDRS运动评分最大改善率与首发症状对侧壳核后部11C-CFT摄取信号强度的r值分别为0.513和0.572(P均＜0.01);与首发症状同侧壳核后部11C-CFT摄取信号强度的r值分别为0.452和0.478(P均＜0.05);与基底节其他感兴趣区11C-CFT摄取信号强度无相关性(P＞0.05).结论 Hohen-Yahr Ⅱ期PD多巴胺转运体代谢与多巴胺能反应性这两种生物学标记物具有相关性,有助深入了解PD的病理生理过程.
목적 연구파금삼병(PD)환자적다파알전운체대사여다파알능반응성시부구유상관성.방법 선택13례Hohen-Yabr Ⅱ기PD환자,분별응용급성계제식좌선다파/변사정(50.0/12.5、100.0/25.0、150.0/37.5 mg)시험평개환자적급성다파알능반응성,응용갑지기탁품완연생물(11C-CFT)PET연구기저절구적다파알전운체대사변화.분석복용좌선다파후PD환자적통-PD평분량표운동분량표(UPDRS Ⅲ)평분개선솔여기저절구다파알전운체시종제11C-CFT섭취강도적상관성.결과 13례PD환자수발증상지체시측적각핵후부11C-CFT섭취신호결손,11례환자수발증상지체동측적각핵후부11C-CFT섭취신호부분결손.수발증상지체대측적각핵후부11C-CFT섭취신호강도저우수발증상동측,차이유통계학의의(P＜0.01).PD환자재좌선다파/변사정100.0/25.0 mg화150.0/37.5 mg제량수평적UPDRS운동평분최대개선솔여수발증상대측각핵후부11C-CFT섭취신호강도적r치분별위0.513화0.572(P균＜0.01);여수발증상동측각핵후부11C-CFT섭취신호강도적r치분별위0.452화0.478(P균＜0.05);여기저절기타감흥취구11C-CFT섭취신호강도무상관성(P＞0.05).결론 Hohen-Yahr Ⅱ기PD다파알전운체대사여다파알능반응성저량충생물학표기물구유상관성,유조심입료해PD적병리생리과정.
Objective To investigate the relationship between metabolism of dopamine transporter and levodopa-responsiveness in patients with Parkinson's disease(PD).Methods Thirteen patients with PD of Hohen-Yahr stage Ⅱ were enrolled in this study.The acute consecutive levedopa/benserazide (50.0/12.5 mg,100.0/25.0 mg,150.0/37.5 mg)tests were used to assess the patients' motor responses.The dopamine transporter binding were assessed with 11C-CFT PET specific in putamen,eaudate nucleus and occipital cortex.The correlation between the improvement of UPDRS Ⅲ and 11C-CFT PET the uptaking capability was analyzed.Results The marked reduction of 11 C-CFT uptake was observed in posterior putamen in patients with PD.The reduction of tracers uptake in posterior putamen contralateral to onset side was more significant than the posterior putamen ipsilateral to onset side (P＜0.01 ).There was significant correlation between 11C-CFF uptake in posterior putamen contralateral to onset side and the improvement of UPDRS motor subscale in test with levedopa/benserazide 100.0/25.0 mg or 150.0/37.5 mg(r=0.513,r=0.572,P＜0.01 ).There was also significant correlation between 11C-CFT uptake in posterior putamen ipsilateral to onset side and the improvement of UPDRS motor subscale in test with levedopa/benserazide 100.0/25.0 mg or 150.0/37.5 mg (r=0.452,r=0.478,P＜0.01 ).There was no correlation between 11C-CFT uptake in basal ganglia and the improvement of UPDTRS motor subscale in test with levedopa/benserazide 100/25mg or 150/37.5 mg(P＞0.05 ).Conclusion There is correlation between metabolism of dopamine transporter and levedopa responsiveness in PD patients of Hoben-Yahr Ⅱ ,which is helpful for the investigation of the pathophysiology.