高红铃;杨清梅;薛峥;王丹蕾;熊永洁;

• 1:华中科技大学同济医学院附属同济医院神经内科

摘要(Abstract)：

目的探讨帕金森病(Parkinson disease,PD)患者在经颅中脑超声(transcranial midbrain sonography,TCS)下的黑质高回声与临床特点的关系,以寻找可能影响因素。方法纳入2017年11月至2019年12月作者医院收治的PD患者200例,进行TCS检查,收集PD患者的一般资料、黑质高回声资料,以及疾病严重程度、生活质量、运动症状、睡眠障碍、血清铜等临床资料,分析黑质高回声的影响因素。结果共178例PD患者完成TCS,其中男116例、女62例,PD患者黑质高回声面积为(0.395±0.167)cm~2;多元逐步线性回归分析显示血清铜(t=2.000,P=0.048)、帕金森病统一评定量表检查(Unified Parkinson's Disease Rating Scale,UPDRS)第二部分(UPDRSⅡ)得分(t=3.063,P=0.003)是黑质高回声面积的独立影响因素。结论 PD患者的血清铜、UPDRSⅡ得分可能是黑质高回声面积的独立影响因素。

关键词(KeyWords)： 帕金森病;经颅中脑超声;黑质高回声;影响因素

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金资助项目(91849121)

作者(Author): 高红铃;杨清梅;薛峥;王丹蕾;熊永洁;

Email:

DOI:

参考文献(References)：

• [1] Heinzel S,Berg D,Gasser T,et al.Update of the MDS research criteria for prodromal Parkinson's disease[J].Mov Disord,2019,34(10):1464-1470.
• [2] Becker G,Seufert J,Bogdahn U,et al.Degeneration of substantia nigra in chronic Parkinson's disease visualized by transcranial color-coded real-time sonography[J].Neurology,1995.45(1):182-184.
• [3] Gaenslen A,Unmuth B,Godau J,et al.The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson's disease:a prospective blinded study[J].Lancet Neurol,2008.7(5):417-424.
• [4] 中华医学会神经病学分会帕金森病及运动障碍学组,中国医师协会神经内科医师分会帕金森病及运动障碍专业.中国帕金森病的诊断标准(2016版)[J].中华神经科杂志,2016,49(4):268-271.
• [5] Postuma RB,Berg D,Stern M,et al.MDS clinical diagnostic criteria for Parkinson's disease[J].Mov Disord,2015,30(12):1591-1601.
• [6] Bartova P,Skoloudik D,Bar M,et al.Transcranial sonography in movement disorders[J].Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub,2008,152(2):251-258.
• [7] Stebbins GT,Goetz CG,Burn DJ,et al.How to identify tremor dominant and postural instability/gait difficulty groups with the movement disorder society unified Parkinson's disease rating scale:comparison with the unified Parkinson's disease rating scale[J].Mov Disord,2013,28(5):668-670.
• [8] Zhou HY,Sun Q,Tan YY,et al.Substantia nigra echogenicity correlated with clinical features of Parkinson's disease[J].Parkinsonism Relat Disord,2016,24:28-33.
• [9] Behnke S,Runkel A,Kassar HA,et al.Long-term course of substantia nigra hyperechogenicity in Parkinson's disease[J].Mov Disord,2013,28(4):455-459.
• [10] Jesus-Ribeiro J,Sargento-Freitas J,Sousa M,et al.Substantia nigra hyperechogenicity does not correlate with motor features in Parkinson's disease[J].J Neurol Sci,2016,364:9-11.
• [11] Harrison MB,Wylie SA,Frysinger RC,et al.UPDRS activity of daily living score as a marker of Parkinson's disease progression[J].Mov Disord,2009,24(2):224-230.
• [12] Goetz CG,Tilley BC,Shaftman SR,et al.Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS):scale presentation and clinimetric testing results[J].Mov Disord,2008,23(15):2129-2170.
• [13] Zecca L,Berg D,Arzberger T,et al.In vivo detection of iron and neuromelanin by transcranial sonography:a new approach for early detection of substantia nigra damage[J].Mov Disord,2005.20(10):1278-1285.
• [14] Berg D,Godau J,Riederer P,et al.Microglia activation is related to substantia nigra echogenicity[J].J Neural Transm (Vienna),2010,117(11):1287-1292.
• [15] Yu SY,Cao CJ,Zuo LJ,et al.Clinical features and dysfunctions of iron metabolism in Parkinson disease patients with hyper echogenicity in substantia nigra:a cross-sectional study[J].BMC Neurol,2018,18(1):9.
• [16] Walter U,Krolikowski K,Tarnacka B,et al.Sonographic detection of basal ganglia lesions in asymptomatic and symptomatic Wilson disease[J].Neurology,2005,64(10):1726-1732.
• [17] Skowrońska M,Litwin T,Kurkowska-Jastrz?bska I,et al.Transcranial sonography changes in patients with Wilson's Disease during de-coppering therapy[J].Neurol Neurochir Pol,2020,54(2):185-192.
• [18] Genoud S,Senior AM,Hare DJ,et al.Meta-analysis of copper and iron in Parkinson's disease brain and biofluids[J].Mov Disord,2020,35(4):662-671.
• [19] Davies KM,Mercer JF,Chen N,et al.Copper dyshomoeostasis in Parkinson's disease:implications for pathogenesis and indications for novel therapeutics[J].Clin Sci (Lond),2016,130(8):565-574.
• [20] Huang YW,Jeng JS,Tsai CF,et al.Transcranial imaging of substantia nigra hyperechogenicity in a Taiwanese cohort of Parkinson's disease[J].Mov Disord,2007,22(4):550-555.