Objective To investigate the effect of subthalamic nucleus stimulation ( STN-DBS) in Parkinson disease ( PD) brain function in patients with local glucose metabolism abnormal.Methods From June 2011 to June 2014, 60 cases of PD patients in Shiyan people's Hospital, Hubei Medical College were enrolled in this study, they were randomly divided into observation group and control group with 30 cases in each group.Control group was given oral levodopa daily, the observation group based on the treatment in the control group, also added the uplink STN-DBS treatment, before treatment and after treat-ment for 3 months, using Unified Parkinson's Disease Rating Scale ( UPDRS) to assess motor function of patients in two groups respectively, using the Montreal Cognitive Assessment Scale ( MoCA) and mini mental state table ( MMSE) to evaluate neural function and patients were underwent the resting F-deoxyglucose FDG/PET examination.Results Compared with before treat-ment, after treatment, the two groups of patients'UPDRS total score decreased significantly ( P <0.05), the observation group's score were lower than the control group ( P <0.05);and the MMSE, MOCA score were only improved in the obser-vation group after treatment ( P <0.05), and significantly higher than control group ( P <0.05).By FDG /PET, the ob-servation group after treatment's frontal lobe, temporal lobe, parietal lobe, occipital lobe, caudate nucleus, hammer-shaped nucleus, cerebellum, thalamus, cingulate cortex and other parts of the semi-quantitative metabolic radiation count was signifi-cantly higher than before treatment ( P <0.05), after treatment, each brain region metabolic semi-quantitative radiation count differences in the control group was not shown statistically significant ( P >0.05), and significantly higher in the obser-vation group than the control group ( P <0.05).After treatment, observation group's daily oral dose of levodopa significantly less than before treatment and control group ( P <0.05) , dyskinesia and motor fluctuations were significantly lower than inthe control group (3 y.33%vs.26.67%, 0 vs.20.00%, P <0.05).Conclusion The STN-DBS can effectively improve the PD patient's brain glucose metabolism and brain function, promote the coordination of limb, improve limb movement func-tion, improve the quality of life of patients.%目的 探讨丘脑底核电刺激(STN-DBS)对帕金森病(PD)患者脑神经功能及局部糖代谢的影响.方法 选取2011年6月—2014年6月湖北医药学院附属十堰市人民医院PD患者60例,随机分为观察组及对照组各30例,对照组每日给予左旋多巴口服,观察组在对照组基础上行STN-DBS治疗,分别于治疗前及治疗后3个月应用统一帕金森病评定量表(UPDRS)对2组患者运动功能进行评定,采用蒙特利尔认知评估量表(MoCA)及简易精神状态量表(MMSE)评定神经功能,并对患者进行静止期F-脱氧葡萄糖(FDG/PET)检查.结果 与治疗前比较,治疗后2组患者UPDRS总评分显著下降(P<0棗.05),观察组低于对照组(P<0.05);而MMSE、MoCA评分仅观察组治疗后提高(P<0.05),且显著高于对照组(P<0.05).经FDG/PET分析可知,观察组治疗后额叶、颞叶、顶叶、枕叶、尾核、锤状核、小脑、丘脑、扣带回等部位葡糖糖代谢放射计数半定量显著高于治疗前(P<0.05),而对照组治疗后各脑区葡糖糖代谢放射计数半定量与治疗前相比差异无统计学意义(P>0.05),且观察组显著高于对照组(P<0.05).观察组治疗后每日左旋多巴口服剂量显著少于治疗前及对照组(P<0.05),异动症及运动症状波动发生率显著低于对照组(3.33%vs.26.67%,0 vs.20.00%,P<0.05).结论 STN-DBS能有效改善PD患者各脑区葡糖糖代谢及脑神经功能,促进肢体协调、改善肢体运动功能,提高患者生存质量.
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