黑质回声与帕金森病的相关性分析

发布时间：2018-08-31 14:20

【摘要】：目的:探讨脑实质超声在帕金森病诊断中的意义;探讨黑质回声与帕金森病患者的年龄、发病年龄、病程的相关性;探讨不同首发症状帕金森病间的黑质回声差异。方法:选择自2015年12月~2016年9月于吉林大学第一医院就诊的帕金森病患者共78名,纳入帕金森病组,其中12名患者在行脑实质超声检查时因单侧或双侧颞窗穿透不良未参与统计学评估。所有患者均是由神经内科研究帕金森病方向的专家诊断,符合中国帕金森病的诊断标准。选择同期健康志愿者21名,纳入健康对照组,其中3名因颞窗穿透不良未参与统计学评估。上述帕金森病组与健康对照组在年龄及性别上无统计学差异。上述受试对象的脑室质超声检查是由神经内科头-颈血管超声室经验丰富的刘影医师完成。检查者对受试对象的临床情况不知情。收集两组人口学等数据资料,包括性别、年龄、帕金森病患者的发病年龄及病程、脑实质超声测得的中脑面积、黑质回声强度、黑质面积及第三脑室宽度。根据帕金森病患者首发症状的不同分为两组,以震颤为首发症状的患者纳入震颤组,以非震颤包括肌强直、动作缓慢、姿势平衡不稳为首发症状的患者纳入非震颤组,比较两组间黑质回声面积的差异。结果:性别间、年龄间的颞窗穿透能力有差异(P0.05);帕金森病组与健康对照组间的黑质回声面积及黑质回声强度的差异均有统计学差异(P0.05);帕金森病组与健康对照组间的中脑面积、第三脑室宽度无差异;黑质回声面积与患者的年龄、发病年龄、病程不相关;黑质回声面积与黑质回声强度有相关性(P0.05);黑质回声强度、黑质回声面积在性别之间无差异;帕金森病组不同首发症状间的黑质回声面积无差异。结论:1.SN回声强度、SN+面积在PD组、健康对照组间有显著差异,TCS可以作为筛查、诊断PD的高效辅助检查手段;2.老年人及女性尤其老年女性易出现颞窗穿透不良,TCS对老年人尤其老年女性患者的诊断价值有限。
[Abstract]:Objective: to investigate the significance of cerebral parenchyma ultrasound in the diagnosis of Parkinson's disease, to explore the correlation between the echo of substantia nigra and the age, age and course of Parkinson's disease, and to explore the difference of echo of substantia nigra among different initial symptoms of Parkinson's disease. Methods: from December 2015 to September 2016, 78 patients with Parkinson's disease were enrolled in the first Hospital of Jilin University. Twelve of them did not participate in statistical evaluation due to unilateral or bilateral temporal window penetration during cerebral parenchyma ultrasonography. All patients were diagnosed by a specialist in the direction of Parkinson's disease in neurology, in line with the diagnostic criteria for Parkinson's disease in China. Twenty-one healthy volunteers were selected for the same period, and 3 of them were not involved in statistical evaluation because of temporal window penetration. There was no significant difference in age and sex between the Parkinson's disease group and the healthy control group. The ultrasound examination of ventricle was performed by experienced physician Liu Ying in head-cervical ultrasound chamber of neurology department. The examiner was unaware of the clinical condition of the subjects. Two groups of demographic data were collected, including sex, age, onset age and course of Parkinson's disease, midbrain area measured by cerebral parenchyma ultrasound, echo intensity of substantia nigra, area of substantia nigra and width of third ventricle. According to the different initial symptoms of Parkinson's disease, the patients with tremor were included in the tremor group, and the patients with non-tremor, including myotonia, slow movement and unstable posture balance, were included in the non-tremor group. The difference of echo area of substantia nigra between the two groups was compared. Results: there were significant differences in temporal window penetrating ability between sex and age (P0.05), nigral echo area and substantia nigra echo intensity in Parkinson's disease group and healthy control group (P0.05), midbrain area in Parkinson's disease group and healthy control group. There was no difference in the width of the third ventricle, there was no correlation between the echo area of the substantia nigra and the age of the patient, the age of onset, the course of disease, the area of the echo of the substantia nigra was correlated with the echo intensity of the substantia nigra (P0.05), the echo area of the substantia nigra had no difference between the sexes. There was no difference in echogenic area of substantia nigra among different initial symptoms in Parkinson's disease group. Conclusion 1. SN echo intensity and SN area in PD group and healthy control group were significantly different. TCS could be used as screening method for diagnosis of PD. The diagnostic value of TCS in the elderly, especially in elderly women, is limited.
【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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