帕金森病患者血脑屏障功能障碍的定量MRI研究

发布时间：2018-06-20 02:58

本文选题：帕金森病 + 血脑屏障　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:本文通过静脉注射钆双胺注射液行磁共振动态增强序列(dynamic contrast-enhanced MRI,DCE-MRI)检查,探究帕金森病(Parkinson′s disease,PD)患者是否存在血脑屏障(Blood-Brain Barrier,BBB)的破坏;如果存在血脑屏障的破坏,那么血脑屏障的破坏与PD疾病严重程度是否相关;为发现和研究帕金森病发病机制新的靶点和信号通路提供宝贵资源,为发现及测试新药物递送途径提供有价值的平台。对象与方法:依据中国帕金森病的诊断标准2016(版)收集2016年5月至2017年5月期间就诊于吉林大学中日联谊医院神经内一科的住院及门诊确诊为帕金森病患者21例组成PD患者组及14例同年龄段健康体检及健康志愿者组成正常对照组;所有入组人员均行常规核磁平扫(magnetic resonance imaging,MRI)及静脉注射钆双胺注射液行DCE-MRI检查,应用计算机OK软件系统Patlak药代动力学模型计算出颅内黑质、尾状核、苍白球、壳核、丘脑感兴趣区(Region of interest,ROI)神经核团容积转运常数(Transfer constant,Ktrans)纹理参数(应用灰度共生矩阵法gray level cooccurrence matrix,GLCM),对PD患者首发侧与正常对照组、PD患者首发侧与非首发侧、PD患者早期与中晚期感兴趣区神经核团Ktrans纹理参数进行比较,当P0.05认为差异有统计学意义。结果:本实验研究,用非参数秩和检验统计学方法对PD患者组及正常对照组颅内各感兴趣区神经核团Ktrans纹理参数进行比较分析,PD患者首发侧苍白球Ktrans纹理参数高于正常对照组苍白球(P=0.018),差异有统计学意义,而黑质、尾状核、壳核、丘脑两组比较差异无统计学意义(P0.05);PD患者组首发侧黑质Ktrans纹理参数显著高于非首发侧黑质(P=0.005),差异有统计学意义,而尾状核、苍白球、壳核、丘脑Ktrans纹理参数比较差异无统计学意义(P0.05);对早期PD患者与中晚期PD患者首发侧黑质、尾状核、苍白期、壳核、丘脑Ktrans纹理参数进行比较差异无统计学意义(P0.05),对早期PD患者与中晚期PD患者非首发侧黑质、尾状核、苍白期、壳核、丘脑Ktrans纹理参数进行比较差异无统计学意义(P0.05)。结论:本研究认为PD患者首发侧苍白球、黑质区存在血脑屏障微渗漏,且血脑屏障破坏程度可能与帕金森病严重程度相关。
[Abstract]:Objective: to investigate whether the blood brain barrier (Blood-Brain Barrier Barrier BBB) is destroyed in patients with Parkinson's disease (PD) by intravenous gadolinium diamine injection, if there is a blood brain barrier, if there is a Blood-Brain Barrier BBB in patients with Parkinson's disease (PD), if there is a Blood-Brain Barrier (BBB), if there is a Blood-Brain Barrier (BBB) in patients with Parkinson's disease (PD), Whether the damage of blood-brain barrier is related to the severity of PD provides valuable resources for the discovery and study of new targets and signaling pathways of Parkinson's disease and a valuable platform for discovering and testing new drug delivery pathways. Participants and methods: according to Chinese diagnostic criteria for Parkinson's disease (2016), 21 patients with Parkinson's disease were collected from May 2016 to May 2017 in the Department of Neurology, Sino-Japanese Friendship Hospital of Jilin University. The patients with PD and 14 healthy volunteers of the same age were made up of normal control group. All the patients were examined by conventional magnetic resonance imaging (resonance) and intravenous gadolinium diamine injection (DCE-MRI). The intracranial substantia nigra, caudate nucleus, globus pallidus and putamen nucleus were calculated by using Patlak pharmacokinetic model of computer OK software system. Region of interest in thalamus (region of interest) and transfer Ktranstexture parameters (using gray level co-occurrence matrix method gray level cooccurrence matrixMr GLCMM), the first and non-initial sides of PD patients were compared with normal controls in the early and middle stages of PD. The texture parameters of Ktrans in the late region of interest were compared. When P0.05 thought the difference was statistically significant. Results: in this study, Comparison of Ktrans texture parameters of neuronuclei in different regions of Intracranial interest in patients with PD and normal controls by Non-parametric Rank Sum Test; Ktrans texture parameters of the first pallidus in PD patients were higher than those in normal controls. The difference was statistically significant. However, there was no significant difference between the substantia nigra, caudate nucleus, putamen nucleus and thalamus. The Ktrans texture parameters of the first substantia nigra in the PD group were significantly higher than those in the non-first side of substantia nigra P0. 005, and the difference was statistically significant, while that in the caudate nucleus, globus pallidus, putamen nucleus, and putamen. There was no significant difference in Ktrans texture parameters of thalamus between early PD patients and middle and late PD patients (P 0.05), the first side of substantia nigra, caudate nucleus, pallidus, putamen nucleus were observed in early and late PD patients. There was no significant difference in Ktrans texture parameters of thalamus between early PD patients and middle and late PD patients. There was no significant difference in Ktrans texture parameters between early PD patients and middle and late PD patients, such as substantia nigra, caudate nucleus, pallid phase, putamen nucleus and thalamus (P 0.05). Conclusion: this study suggests that microleakage of blood-brain barrier exists in the first globus pallidus and substantia nigra in PD patients, and the degree of breakdown of blood-brain barrier may be related to the severity of Parkinson's disease.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.5

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