【摘要】 目的:研究临床中普遍应用的UPDRS量表中第Ⅱ、Ⅲ见和Ⅴ部分评分与多巴胺转运体（Dopamine trabsporter,DAT）PET功能显像的相关性,推断这些评分在帕金森病（Pakinson disease,PD）临床应用的可靠性。方法:以¹⁸F订标记的FP-CIT为特异性配体,应用PET检测了31例原发性PD患者双侧基底节区（包括尾状核、前壳核和后壳核）DAT数量。将这些患者的UPDRS中第Ⅱ、Ⅲ和Ⅴ部分的临床评分与双侧基底节不同区域DAT均值进行相关性分析。结果:UPDRSⅡ、Ⅲ、Ⅴ评分与尾状核、前壳核和后壳核DAT呈显著负相关。它们与后壳核DAT的相关系数γ分别为-0.363,-0.473及-0.532。在UPDRSⅢ中的PD主要症状评分中,肌强直评分与上述3个基底节不同区域DAT均呈显著负相关,动作迟缓评分仅与后壳核DAT呈显著负相关,而震颤评分与这3个区域中的任何区域DAT均无相关性。结论:UPDRSⅡ、Ⅲ、Ⅴ评分均能客观反映PD患者的严重程度,其中UPDASⅢ相对更全面可靠。PD患者震颤发生的机制可能与黑质纹状体通路障碍无关。更多还原

【Abstract】 Aim:To evaluate the reliability of the subscales of UPDRS in clinical setting of Parkinson disease (PD) . Methods: [18F]-FP-CIT PET imaging PET and the tracer [18F]-FP-CIT were used to measure dopamine transporters (DAT) binding in the striatum of 31 Parkinsonian patients, and its correlation with the subscales of UPDRS, Ⅱ , Ⅲ and Ⅴ was determined by calculating two-tailed Pearson correlation coefficients of SPSS. Results: The subscale Ⅱ , Ⅲ and Ⅴ of UPDRS showed significantly negative correlation with DAT binding in caudate, anterior putamen and posterior putamen. The severity of rigidity and hypokinesia had a clear association with reduced DAT binding in the posterior putamen,whereas no such association was seen with tremor. Conclusion: The subscale Ⅱ , Ⅲ and Ⅴ of UPDRS is reliable to reflect the severity of PD, in which UPDRS Ⅲ seems to be more comprehensive and objective. Dysfunction in neuronal pathways other than the nigrostriatal dopamine system are speculated in the genesis of tremor in Parkinson’ s disease.更多还原