脑脊液α-突触核蛋白和SWI在早期帕金森病诊断中的价值
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摘要
目的探讨脑脊液α-突触核蛋白测定和SWI在早期帕金森病(Parkinson’s disease,PD)诊断中的价值。方法收集郑州大学第一附属医院2015-08—2017-12确诊的PD患者,根据H-Y分级分为早期PD组和中晚期PD组,招募同一时期内年龄及性别与PD组相匹配的健康志愿者,采用酶联免疫吸附测定试剂盒检测脑脊液α-突触核蛋白,所有患者及对照组同时行头颅横断位T_1WI、T_2WI和SWI成像检查。结果 PD组脑脊液中α-突触核蛋白水平低于对照组;不同分期PD比较,中晚期PD组脑脊液中α-突触核蛋白水平低于早期PD组,差异有统计学意义(P<0.01)。头颅SWI分析显示,PD组与对照组的脑铁沉积比较,在苍白球、尾状核头和黑质区差异有统计学意义(P<0.05),早期PD组与中晚期PD组在相同部位铁沉积比较,差异无统计学意义(P>0.05);在红核和壳核区域,PD组与对照组铁沉积比较,差异无统计学意义(P>0.05),早期PD组与中晚期PD组铁沉积比较,差异无统计学意义(P>0.05)。结论脑脊液α-突触核蛋白是PD早期病理改变的重要生物学指标。SWI通过检测脑内异常铁沉积,可用于协同诊断PD。
Objective To investigate the levels ofα-synuclein in cerebrospinal fluid andSWI in patients with early-stage Parkinson's disease.Methods SWI and cerebrospinal fluid α-synuclein of patients with the group of early-stage PD,the group of middle-and late-stage PD and the group of healthy controls were obtained from Department of Neurology in the First Affiliated Hospital of Zhengzhou University.Results The levels of α-synucleinin cerebrospinal fluid of patients with early-stage PD were significant decreased than the control group(P<0.01).The levels of α-synucleinin cerebrospinal fluid of patients with middle-and late-stage PDwere significant decreased thanthe group of early-stage PD(P<0.01).The phase value of CAU,Snr and PUT in PD group were significantly lower than that in the control group(P<0.05).The phase value of RN and GP had no significant difference between the groups(P>0.05).Conclusion The levels of α-synuclein in cerebrospinal fluid is important to early-stage Parkinson's disease.SWI maybe a new method for the study of early diagnosis in PD.
Objective To investigate the levels ofα-synuclein in cerebrospinal fluid andSWI in patients with early-stage Parkinson's disease.Methods SWI and cerebrospinal fluid α-synuclein of patients with the group of early-stage PD,the group of middle-and late-stage PD and the group of healthy controls were obtained from Department of Neurology in the First Affiliated Hospital of Zhengzhou University.Results The levels of α-synucleinin cerebrospinal fluid of patients with early-stage PD were significant decreased than the control group(P<0.01).The levels of α-synucleinin cerebrospinal fluid of patients with middle-and late-stage PDwere significant decreased thanthe group of early-stage PD(P<0.01).The phase value of CAU,Snr and PUT in PD group were significantly lower than that in the control group(P<0.05).The phase value of RN and GP had no significant difference between the groups(P>0.05).Conclusion The levels of α-synuclein in cerebrospinal fluid is important to early-stage Parkinson's disease.SWI maybe a new method for the study of early diagnosis in PD.
引文
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[10] MAHLKNECHT P,HOTTER A,HUSSL A,et al.Significance of MRI in diagnosis and differential diagnosis of Parkinson’s disease[J].Neurodegener Dis,2010,7:300-318.
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[12] HAACKEE M,XU Y,CHENG Y C,et al.Susceptibil-ity weighted imaging (SWI)[J].Magn Reson Med,2004,52:612-618.
[13] HAACKE E M,CHENG N Y,HOUSE M J,et al.Imaging iron stores in the brain using magnetic resonance imaging[J].Magn Reson Imaging,2005,23:1-25.
[14] SEHGAL V,DELPROPOSTO Z,HAACKE E M,et al.Clinical applications of neuroimaging with susceptibility-weighted imaging[J].J Magn Reson Imaging,2005,22:439-450.
[15] BERG D,HOCHSTRASSER H.Iron metabolism in Parkinsonian syndromes[J].Mov Disord,2006,21:1 299-1 310.
[16] HAACKE E M,AYAZ M,KHAN A,et al.Establishing a baseline phase behavior inmagnetic resonance imaging to determine normalvs abnormal iron contentin brain[J].J Magn Reson Imaging,2007,26:256-264.
[17] HARDERS L,HOPPK M,WARD H,et al.Mineralization of the deep gray matter with age:a retrospective review with susceptibility weighted MR imaging[J].AJNR Am J Neuroradiol,2008,29:176-183.
[18] FRIEDMAN A,GALAZKA-FRIEDMAN J,KOZIOROWSKI D.Iron as a cause of Parkinson disease:a mythorawell-established hypothesis?[J].Parkinson-ism Relat Disord,2009,15(suppl 3):212-214.
[19] ABBASI N,MOHAJER B,ABBASI S,et al.Relationship between cerebrospinal fluid biomarkers and structural brain network properties in Parkinson'sdisease[J].Mov Disord,2018,33(3):431-439.
[20] GUPTA D,SAINI J,KESAVADAS C,et al.Utility of susceptibility weighted MRI in differentiating Parkin-son’s disease and atypical parkinsonian syndromes[J].Neuroradiology,2010,52:1 087-1 094.
[21] WANG Y,BUTROS S C,SHUAI X,et al.Different iron-deposition patterns of multiple system atrophy with predominant parkinsonism and idiopathetic Parkinson diseases demonstrated by phase-corrected susceptibility-weighted imaging[J].AJNR Am J Neuroradiol,2012,33:266-273.
[22] KRAFT E,TRENKWALDER C,AUER D P.T2*-weighted MRI differentiates multiple system atrophy from Parkinson’s disease[J].Neurology,2002,59:1 256-1 267.
[23] HALLER S,BADOUD S,NGUYEN D,et al.Differentiation between Parkinson disease and other forms of Parkinsonism using support vector machine analysis of susceptibility-weighted imaging(SWI):initial results[J].Eur Radiol,2013,23:12-19.
[24] ZHANG J,ZHANG Y,WANG J,et al.Characterizing iron deposition in Parkinson’s disease using susceptibility weighted imaging:an invivo MR study[J].Brain Res,2010,1 330:124-130.
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