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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~(18)F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。
OBJECTIVE: To investigate the correlation between the partial scores of Part II, III and V of PET and the functional imaging of dopamine transporter (DAT) in the UPDRS scale commonly used in clinical practice, and to infer the relevance of these scores in Parkinson’s disease PD) clinical application of reliability. Methods: Bilateral basal ganglia (including caudate nucleus, anterior putamen and posterior putamen) of 31 patients with primary PD were detected by PET with FP-CIT labeled with ~ (18) F. DAT quantity. The clinical scores of Part II, III and V of UPDRS in these patients were compared with the DAT mean of different regions of bilateral basal ganglia. Results: UPDRS Ⅱ, Ⅲ, Ⅴ scores were significantly negatively correlated with DAT in caudate nucleus, caudate putamen and posterior putamen. Their correlation coefficients γ with the posterior putamen were -0.363, -0.473 and -0.532, respectively. In the main symptom score of PD in UPDRS Ⅲ, myotonia score was significantly negatively correlated with DAT in different regions of the three basal ganglia mentioned above, and the delayed action score was only negatively correlated with DAT in posterior putamen. However, the scores of tremor with these three regions No regional DAT in any correlation. Conclusion: UPDRS Ⅱ, Ⅲ, Ⅴ scores can objectively reflect the severity of PD patients, including UPDAS Ⅲ relatively more comprehensive and reliable. The mechanism of tremor in PD patients may not be related to the nigrostriatal pathway disorders.