《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (08): 758-760.

• 临床研究 • 上一篇    下一篇

路易体痴呆与帕金森病痴呆的脑葡萄糖代谢比较研究

冯涛;芦林龙;张璇;李伟; 王拥军   

  1. 首都医科大学附属北京天坛医院神经内科，北京市 100050
  • 收稿日期:2009-05-14 出版日期:2009-08-01 发布日期:2009-08-01

Comparison of Cerebral Glucose Metabolism between Dementia with Lewy Bodies and Parkinson's Disease Dementia

FENG Tao,LU Lin-long,ZHANG Xuan,et al   

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2009-05-14 Published:2009-08-01 Online:2009-08-01

PDF (PC)

被引次数

11

摘要： 目的 研究并比较路易体痴呆与帕金森病痴呆在脑葡萄糖代谢方面的特征。方法 路易体痴呆患者25例和帕金森病痴呆患者31例。受试者静脉注射示踪剂氟18脱氧葡萄糖(18F-FDG，剂量为1.85～3.7 MBq/kg)，然后接受头部正电子发射断层扫描(PET)。用迭代法重建获得脑图像，在脑横断面图像中分别取尾状核头、壳核、双侧额叶皮层、双侧顶叶皮层、双侧颞叶皮层、双侧枕叶皮层和小脑皮层为感兴趣区(ROI)。以脑内各ROI与小脑半球ROI的FDG摄取强度的比值为指标进行分析。结果 路易体痴呆与帕金森病痴呆在额叶前部皮层、颞叶前部皮层、顶叶后部皮层的FDG摄取均下降(P>0.05)。路易体痴呆在枕叶皮层的FDG摄取下降比帕金森病痴呆显著(P<0.01)。路易体痴呆的纹状体FDG摄取对称性降低。帕金森病痴呆的纹状体FDG摄取降低呈不对称性，首发症状对侧的纹状体FDG摄取低于首发症状同侧(P<0.05)。结论 路易体痴呆与帕金森病痴呆在皮层和基底节的葡萄糖代谢方面有相似性的变化，也存在差异。这些特征有助于两者的鉴别诊断。

关键词: 路易体痴呆, 帕金森病, 痴呆, 正电子发射断层扫描

Abstract: Objective To investigate the feature of cerebral glucose metabolism of dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Methods Twenty-five DLB patients and Thirty-one PDD patients underwent positron emission tomography(PET) with 18F-fluorodeoxyglucose (18F-FDG) showing glucose metabolism. The region of interest (ROI) was selected from frontal cortex, temporal cortex, parietal cortex, occipital cortex, cerebellum cortex and corpora striata. 18F-FDG metabolism ratios between various cerebral regions and cerebellum cortex were compared as an indicator of regional cerebral glucose metabolic patterns.Results FDG metabolism ratio of frontal cortex, occipital cortex, parietal cortex, temporal cortex and corpus striatum decreased similarly in DLB and PPD (P>0.05). FDG metabolism ratio of occipital cortex decreased more significantly in DLB than in PDD (P<0.01). The decrease of FDG metabolism in corpus striatum of DLB was symmetric. For patients with PDD, FDG metabolism in corpus striatum contralateral to onset side decreased more significantly than that of corpus striatum ipsilateral to onset side (P<0.05). Conclusion There are similarities and discrepancies in cerebral glucose metabolism between DLB and PDD. These features may be useful in differential diagnosis between these two kinds of Lewy body disease.

Key words: dementia with lewy bodies, Parkinson's disease, dementia, positron emission tomography (PET)