帕金森病中脑黑质3D多体素1H-MRS研究

摘要

Objective To study the Parkinson's disease of substantia nigra neuronal metabolites changes and its clinical signif -icance.Methods This study included 30 patients with PD, 20 healthy controls.All of subjects were examined with 3D multi-voxel 1H-MRS scan and obtained the substantia nigra metabolites relative ratio (NAA/Cr, NAA/Cho, NAA/(Cr+Cho).Then we compared the relative ratio of the PD group and the healthy control , the asymmerric PD group of bilateral , and the different grade PD group.Results 1) The PD group and healthy control NAA/Cr, NAA/Cho, NAA/(Cho+Cr) had obvious difference ( P <0.05); 2) The PD group limb contralateral and limb ipsilateral NAA/Cr, NAA/Cho, NAA/(Cho +Cr) had obvious difference ( P <0.05);3) The H-Y graded mild group and severe group of PD NAA/Cr, NAA/Cho, NAA/(Cho+Cr) had ob-vious difference ( P <0.05).Conclusion The PD substantia nigra metabolites had changes .the asymmerric PD group of bilat-eral had difference;the H-Y graded mild group and the heveier group had difference;The substantia nigra 1 H-MRS had the im-portant significance in the early diagnosis of PD .%目的：探讨1H-MRS检测帕金森病（Parkinson＇s disease，PD）黑质神经元代谢产物变化的意义。方法 PD患者30例，正常对照组20例。采用3．0T MRI对PD患者及正常对照者黑质进行3D多体素1 H-MRS检测，获得代谢物间相对比值，NAA／Cr、NAA／Cho、NAA／（Cho＋Cr）。然后，对PD组与正常对照组黑质代谢产物进行比较；对非对称PD患者两侧黑质代谢产物进行比较；对不同病情程度的PD的黑质代谢产物进行比较。结果1） PD组与对照组黑质NAA／Cr、NAA／Cho、NAA／（Cho＋Cr）相对比差异有显著性（ P ＜0．05）；2） PD组患肢对侧与患肢同侧黑质NAA／Cr、NAA／Cho、NAA／（Cho＋Cr）相对比差异有显著性（ P ＜0．05）；3）H-Y分级较轻组与较重组组间黑质NAA／Cr、NAA／Cho、NAA／（Cho＋Cr）相对比差异有显著性（ P ＜0．05）。结论 PD患者黑质代谢产物有变化，非对称性PD患者两侧黑质代谢产物含量不同，病情较轻组与较重组黑质代谢产物有差异，1 H-MRS检测黑质代谢产物含量对PD早期诊断具有重要作用。