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[帕金森病患者的脑血流与氧代谢]

[Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease].

作者信息

Kitamura S, Ujike T, Kuroki S, Sakamoto S, Soeda T, Iio M, Terashi A

机构信息

Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

出版信息

No To Shinkei. 1988 Oct;40(10):979-85.

PMID:3264173
Abstract

The distribution of cerebral blood flow and metabolism is related to neuronal activity. Cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) in ten patients with Parkinson's disease and five age-matched normal control subjects were measured with positron emission tomography (PET) using 15O2, C15O2 steady state inhalational technique to investigate functional changes of the cortex and the basal ganglia in Parkinson's disease. All patients had no history of cerebrovascular disease and CT scan showed no abnormal findings except for moderate cerebral atrophy in only one patient. When the level of clinical disability was related on the scale of Hoehn and Yahr, one patient was stage I, four were stage II, four were stage III, and one was stage IV. Psychic symptoms which include hallucination, depression, and dementia were recognized in four patients. One of these four patients was mildly demented. Four patients were newly diagnosed and had never been treated with antiparkinsonian medication before. Before the patients had their PET study their antiparkinsonian medication was discontinued for more than three days. But in two patients PET study was performed without discontinuity of antiparkinsonian medication. The values for regional CBF and regional CMRO2 were lower in the patients than in the normal control subjects, especially in the frontal cortex there was a significant decrease of CBF and CMRO2. There was no discrepancy between CBF and CMRO2 both in the patients and the normal control. CBF and CMRO2 in the cortex and the basal ganglia were not correlated with the severity of tremor, bradykinesia, and rigidity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

脑血流和代谢的分布与神经元活动有关。采用15O2、C15O2稳态吸入技术,通过正电子发射断层扫描(PET)测量了10例帕金森病患者和5例年龄匹配的正常对照者的脑血流量(CBF)、脑氧代谢率(CMRO2)和氧摄取分数(OEF),以研究帕金森病患者皮质和基底神经节的功能变化。所有患者均无脑血管疾病史,CT扫描除1例有中度脑萎缩外无异常发现。根据Hoehn和Yahr分级标准评估临床残疾程度,1例为I期,4例为II期,4例为III期,1例为IV期。4例患者出现包括幻觉、抑郁和痴呆在内的精神症状。这4例患者中有1例轻度痴呆。4例为新诊断患者,此前从未接受过抗帕金森病药物治疗。在进行PET研究前,患者停用抗帕金森病药物超过3天。但有2例患者在未停用抗帕金森病药物的情况下进行了PET研究。患者的局部CBF和局部CMRO2值低于正常对照者,尤其是额叶皮质的CBF和CMRO2显著降低。患者和正常对照者的CBF和CMRO2之间无差异。皮质和基底神经节的CBF和CMRO2与震颤、运动迟缓及强直的严重程度无关。(摘要截选至250词)

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