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背景:司来吉兰可有效缓解早期帕金森病的运动障碍症状,但对于早期帕金森病预后的影响争议甚多。神经影像学的研究进展使得帕金森病多巴胺能神经元的变性程度客观标记成为可能。目的:利用影像学观察研究司来吉兰对早期帕金森病多巴胺能神经元的影响。设计:以患者为研究对象的随机对照实验。单位:一所军队医院的神经内科和一所军医大学医院的核医学科、神经内科。对象:2001-04/10第二军医大学长海医院神经内科帕金森病专病门诊筛选的25例未经任何药物治疗的早期帕金森病患者。干预:25例患者随机分为安慰剂组和司来吉兰治疗组,安慰剂组13例,司来吉兰治疗组12例。联合帕金森病量表(UnifiedParkinson’sdiseaseratingscale,UPDRS)评分后,按照逐渐增量的原则,分别给予安慰剂和司来吉兰治疗(起始剂量均为0.05mg)。每周增加0.05mg,经过4周的加量期,剂量均达到0.2mg,此后维持剂量恒定。于入组时、治疗13个月后分别行多巴胺转运蛋白(99Tcm-TRODAT-1)单光子发射型计算机体层扫描(singlephotonemission-computeredtomography,SPECT)检查,半定量法分析起病肢体对侧、同侧纹状体放射计数。于入组时、治疗6个月、治疗13个月后分别进行UPDRS评分。主要观察指标:①主要结局:两组治疗13个月后起病肢体对侧、同侧纹状体99Tcm
BACKGROUND: Selegiline is effective in ameliorating the symptoms of dyskinesia in early-stage Parkinson’s disease but is disproportionately affected by the prognosis of early-stage Parkinson’s disease. Progress in neuroimaging has made it possible to objectively label the degree of degeneration of Parkinson’s disease dopaminergic neurons. OBJECTIVE: To study the effect of selegiline on dopaminergic neurons in early stage Parkinson’s disease by imaging studies. Design: Randomized controlled trial of patients. Unit: Department of Neurology, a military hospital and a nuclear medicine department and neurology department of a military medical university hospital. Object: 2001-04 / 10 Department of Neurology, Second Military Medical University Changhai Hospital Parkinson’s disease outpatient screening of 25 cases of patients with early Parkinson’s disease without any drug treatment. INTERVENTIONS: Twenty-five patients were randomized to placebo and selegiline, 13 to placebo, and 12 to selegiline. After the Unified Parkinson’s Disease Scale (UPDRS) score was administered, placebo and selegiline were administered in increments of 0.05 mg each. 0.05mg weekly increase, after 4 weeks of the dosage period, the dose reached 0.2mg, since then to maintain a constant dose. At 13 months after treatment, dopamine transporter (99Tcm-TRODAT-1) single photon emission computed tomography (SPECT) was performed. The contralateral hemisphere Lateral striatal radiation counts. At enrollment, treatment was performed for 6 months and UPDRS scores were assessed after 13 months of treatment. MAIN OUTCOME MEASURES: ① Main Outcomes: The contralateral side of the affected limbs, the ipsilateral striatum 99Tcm