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[帕金森病的鉴别诊断——123I-IBZM单光子发射计算机断层扫描与阿扑吗啡试验对比]

[The differential diagnosis of Parkinson diseases--123I-IBZM-SPECT vs. the apomorphine test].

作者信息

Hierholzer J, Cordes M, Schelosky L, Sander B, Böck J C, David I, Horowski R, Poewe W

机构信息

Strahlenklinik und Poliklinik, Klinikum Rudolf Virchow, Freie Universität Berlin.

出版信息

Rofo. 1993 Jul;159(1):86-90. doi: 10.1055/s-2008-1032726.

Abstract

The aim of our study was to compare the striatal dopamine D2-receptor density as measured by 123I-IBZM-SPECT with the results of the apomorphine-test. 30 patients were studied; 21 with idiopathic Parkinson's disease (IPD), 9 with Parkinson plus syndromes (PPS). Patients with IPD showed a significantly higher striatal IBZM binding as compared to patients with PPS (p = 0.006). A good correlation between IBZM binding and outcome of the apomorphine-test was found (p = 0.006). Low striatal IBZM binding indicates reduced dopamine D2-receptor density. This compromises successful dopaminergic medical therapy and is indicative of non-IPD disease. 123I-IBZM-SPECT could be diagnostic aid in the work-up of patients with extrapyramidal movement disorders. The response to dopaminergic drug treatment might be precluded by IBZM-SPECT in patients with Parkinsonian syndromes.

摘要

我们研究的目的是比较通过123I-碘苄胍单光子发射计算机断层扫描(123I-IBZM-SPECT)测量的纹状体多巴胺D2受体密度与阿扑吗啡试验的结果。研究了30名患者;其中21例为特发性帕金森病(IPD),9例为帕金森叠加综合征(PPS)。与PPS患者相比,IPD患者的纹状体IBZM结合显著更高(p = 0.006)。发现IBZM结合与阿扑吗啡试验结果之间存在良好的相关性(p = 0.006)。纹状体IBZM结合低表明多巴胺D2受体密度降低。这会影响多巴胺能药物治疗的成功,并提示非IPD疾病。123I-IBZM-SPECT可作为锥体外系运动障碍患者检查的诊断辅助手段。IBZM-SPECT可能会排除帕金森综合征患者对多巴胺能药物治疗的反应。

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