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目的:应用99mTc -TRODAT 1SPECT显像多巴胺转运体(DAT)和13 1I -epideprideSPECT显像多巴胺D2 受体,研究早期帕金森(PD)病人中用不同药物单一治疗14个月的随访情况。方法:72例早期(Hoehn&YahrⅠ～Ⅱ级)PD患者双盲、区组随机化方法分为4组,分别给予苯海索6mg·d-1(n =15 ) ;L 多巴制剂(美多巴2 5 0’,每天2 .5片) (n =2 2 ) ;L deprenyl(司来吉兰7.5mg·d-1) (n =2 2 ) ;多巴胺受体激动剂培高利特0 .5mg·d-1(n =13 )并随访14个月。分别在基线,随访7和14个月时,进行临床评分,同时以99mTc -TRODAT 1和13 1I -epidepride为配体,应用SPECT功能显像各组患者基底节区DAT和多巴胺D2 受体,比较不同治疗方案对基底节多巴胺能系统的影响情况。结果:99mTc -TRODAT 1SPECT显像结果显示,苯海索组和多巴制剂治疗组在治疗14个月后,基底节DAT均显著降低(P <0 .0 5 ) ,司来吉兰治疗组和多巴受体激动剂组在治疗7和14个月后,基底节区DAT虽有降低,但与基线比较无统计学意义(P >0 .0 5 )。随访14个月时,与对照组(苯海索组)比,仅受体激动剂组患者基底节区DAT值较高(P <0 .0 5 ) ,即减少程度最小。13 1I- epideprideSPECT显像结果显示,随访7和14个月时各组和基线比较均无显著差异,各组间亦无明显差异。结论:早期PD患者中,用多巴
OBJECTIVE: To investigate the follow-up of 14 months of treatment with different drugs in patients with early Parkinson disease using 99mTc-TRODAT 1 SPECT imaging of dopamine transporter (DAT) and 131I -epidepride SPECT imaging of dopamine D2 receptors. Methods: A total of 72 patients with Hoehn & Yahr grade Ⅰ ~ Ⅱ PD were randomly divided into 4 groups: (N = 2 2); L deprenyl (selegiline 7.5 mg · d -1) (n = 2 2); dopamine receptor agonist pergolide 0.5 mg · D-1 (n = 13) and followed up for 14 months. Clinical scoring was performed at baseline and at follow-up of 7 and 14 months, respectively. At the same time, 99mTc-TRODAT 1 and 131I-epidepride were used as ligands. SPECT imaging was used to detect basal ganglia DAT and dopamine D2 receptors in each group Effects of different treatment regimens on basal ganglia dopaminergic system. Results: 99mTc-TRODAT 1 SPECT imaging showed that the DAT in basal ganglia was significantly decreased (P <0.05) in the trihexyphenidyl and dopa-treated groups after 14 months of treatment, Dopa receptor agonist group after 7 and 14 months of treatment, although the basal ganglia DAT decreased, but compared with the baseline was not statistically significant (P> 0.05). At 14 months of follow-up, basal ganglia DRA only had a higher DAT value (P <0.05) than did the control (trihexyphenidyl) group, indicating the least reduction. Results of 1I-epidepride SPECT imaging showed no significant differences between groups and baseline at follow-up of 7 and 14 months, and there was no significant difference between groups. Conclusion: In early PD patients, dopa was used