【摘要】 目的采用131碘-间碘苄胍(¹³¹I-MIBG)心肌显像方法评估帕金森病（PD）、多系统萎缩（MSA）及特发性震颤（ET）患者的心脏交感神经功能,以期为上述疾病的鉴别探索新的方法。方法收集PD患者25例,MSA患者18例,ET患者11例和正常对照者10例,所有受试者均行¹³¹I-MIBG心肌显像,分别测定计算15 min和4 h两个时间点的心脏/纵膈（H/M）放射性计数比值,作为¹³¹I-MIBG心肌摄取率。结果 PD组15 min和4 h两个时间点的H/M值分别为1.65±0.36和1.50±0.43,MSA组分别为1.97±0.36和2.08±0.57,ET组分别为2.34±0.34和2.46±0.51,对照组分别为2.41±0.26和2.66±0.47。两两比较,PD组两个时间点的H/M值均低于MSA组、ET组和对照组相应值（均P<0.05）,MSA组两个时间点的H/M值均低于对照组相应值（均P<0.05）,ET组与对照组两个时间点的H/M值差异均无统计学意义（均P>0.05）。结论 PD、MSA患者均可发生心脏交感神经功能损害,且PD患者损害更著,而ET患者心脏交感神经功能无明显改变。¹³¹I-MIBG心肌显像可能有助于PD、MSA及ET的鉴别诊断。更多还原

【Abstract】 Objective The present study is to assess the cardiac sympathetic nerve function in patients with Parkinson’s disease（ PD）,multiple system atrophy（ MSA） and essential tremor（ ET） using¹³¹I-MIBG myocardial scintigraphy and to explore a new method for differential diagnosis among them with expectation. Methods Twenty-five PD,eighteen MSA,eleven ET and ten normal controls were enrolled.¹³¹I-MIBG myocardial scintigraphy was performed on each subject and then heart to mediastinum（ H / M） ratios were calculated at two sampled time（ 15 min and 4 h）,which represented the¹³¹I-MIBG myocardial uptake ratios. Results The H / M ratios at two sampled time（ 15 min and 4 h） in the PD group were1. 65 ± 0. 36 and 1. 50 ± 0. 43,and those of the MSA group were 1. 97 ± 0. 36 and 2. 08 ± 0. 57,the ET group were 2. 34 ±0. 34 and 2. 46 ± 0. 51,and the control group were 2. 41 ± 0. 26 and 2. 66 ± 0. 47. The H / M ratios at two sampled time in the PD group were lower than those of the MSA,ET and control group respectively,with statistical significance（ all P <0. 05）. The H / M ratios at two sampled time in the MSA group were significantly lower than those of the control group respectively（ all P < 0. 05）. There was no significant difference in H / M ratios at two sampled time between the ET and control groups（ all P > 0. 05）. Conclusion Cardiac sympathetic dysfunction could occur in both PD and MSA patients,especially in PD patients. In contrast,cardiac sympathetic function remains in ET patients. Above all,¹³¹I-MIBG myocardial scintigraphy may help realize differential diagnosis among PD,MSA and ET patients.更多还原