蔡立君;詹玮;李旭红;廖欣;黄明明;聂红昉;焦玲;
CAI Lijun;ZHAN Wei;LI Xuhong;LIAO Xin;HUANG Mingming;NIE Hongfang;JIAO Lin;Department of Neurology,the Affiliated Hospital of Guizhou Medical University;Guizhou Medical University;Department of Imaging,the Affiliated Hospital of Guizhou Medical University;

• 1:贵州医科大学附院神经内科
• 2:贵州医科大学
• 3:贵州医科大学附院影像科

摘要(Abstract)：

目的:应用3.0T MR磁敏感加权成像技术(SWI)了解α-硫辛酸(LA)对帕金森病(PD)患者黑质的铁螯合作用。方法:选取PD患者40例随机均分为研究组和对照组,在基础治疗的同时,研究组给予LA与单唾液酸四己糖神经节苷脂钠(GM1)进行治疗,对照组仅予GM 1治疗,应用SWI观察两组患者治疗前后黑质相位值变化以评估LA的铁螯合作用。结果:治疗后研究组患者黑质相位值升高,铁沉积减少(P<0.05);对照组治疗前后黑质相位值无明显变化,铁沉积无明显变化,两组比较差异有统计学意义(P<0.05);治疗前后黑质致密带(SNc)宽度、黑质(SN)宽度、SNc/中脑直径、SN面积平均值,研究组与对照组均无明显变化(P>0.05)。结论:SWI检查可评估LA治疗PD对黑质铁沉积的影响,LA是有效治疗PD的金属螯合剂。
Objective: To understand the effect of iron chelation of α-lipoic acid( LA) on substantia nigra of patients with Parkinson's disease( PD) by 3. 0T MR susceptibility weighted imaging( SWI).Methods: 40 patients of PD were randomly divided into experimental group and control group. The experimental group received LA and monosialotetrahexosylgangliosid( GM-1) for treatment while the control group was treated with GM1 only. The changes of substantia nigra phase value of two groups before and after treatment were observed by SWI and the effect of iron chelation of α-lipoic acid( LA) on substantia nigra was evaluated. Results: Compared with before treatment,the substantia nigra phase value of experimental group significantly increased and iron deposition significantly decreased after treatment( P < 0. 05). Compared with before treatment,however,the substantia nigra phase values and iron deposition of control group after treatment showed no significant changes. There were statistically significant differences between the two groups had( P < 0. 05). There were no significant change in the density of the substantia nigra( SNc) width,the substantia nigra( SN) width,SNc / the diameter of the midbrain,the mean value of the SN area between before and after treatment in both groups( P >0. 05). Conclusion: SWI examination can evaluate the effect of LA on the substantia nigra in treatment of PD,and LA is a effective metal chelating agent for the treatment of PD.

关键词(KeyWords)： α-硫辛酸;螯合疗法;帕金森病;黑质;磁敏感加权成像
α-lipoic acid;chelating therapy;Parkinson's disease;substantia nigra;magnetic susceptibility weighted imaging

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金[黔科合J字(2011)2237];; 贵州省科技合作项目[黔科合LH字(2015)7414号]

作者(Author): 蔡立君;詹玮;李旭红;廖欣;黄明明;聂红昉;焦玲;
CAI Lijun;ZHAN Wei;LI Xuhong;LIAO Xin;HUANG Mingming;NIE Hongfang;JIAO Lin;Department of Neurology,the Affiliated Hospital of Guizhou Medical University;Guizhou Medical University;Department of Imaging,the Affiliated Hospital of Guizhou Medical University;

Email:

DOI: 10.19367/j.cnki.1000-2707.2016.07.019

参考文献(References)：

• [1]Ran C,Belin AC.The genetics of Parkinson’s disease:review of current and emerging candidates[J].Journal of Parkinsonism and Restless Legs Syndrome,2014(2014):63-75.
• [2]刘久江,肖勤.铁与帕金森病[J].内科理论与实践,2014(3):232-234.
• [3]Lang AE.In pursuit of prodromal Parkinson's disease[J].The Lancet Neurology,2015(14):27-28.
• [4]Mounsey RB,Teismann P.Chelators in the treatment of Iron accumulationin Parkinson’s disease[J].International Journal of Cell Biology,2012(2012):e983245.
• [5]Youdim MB,Grunblatt E,Mandel S.The copper chelator,D-penicillamine,does not attenuate MPTP induced dopamine depletion in mice[J].Journal of Neural Transmission,2007(2):205-209.
• [6]Forni GL,Balocco M,Cremonesi L,et al.Regression of symptoms after selective iron chelation therapy in a case of neurodegeneration with brain iron accumulation[J].Movement disorders,2008(6):904-907.
• [7]Zorzi G,Zibordi F,Chiapparini L,et al.Iron-related MRI images in patients with pantothenate kinase-associated neurodegeneration(PKAN)treated with deferiprone:Results of a phase II pilot trial[J].Movement Disorders,2011(9):1755-1759.
• [8]Jacoba F,Van Muiswinkel FL,Jongenelen CA,et al.The Neuroprotective antioxidantα-lipoic acid induces detoxication enzymes in cultured astroglial cells[J].Free Radical Research,2010(6):695-699.
• [9]王伟,刘汉杰,吴艳芬,等.α-硫辛酸对帕金森病大鼠脑内多巴胺能神经元的保护作用及其机制探讨[J].中风与神经疾病杂志,2014(5):419-421.
• [10]张静,张云亭,何宁,等.磁敏感加权成像对帕金森病患者丘脑底核的显示价值初探[J].磁共振成像,2011(5):353-357.
• [11]Xu XJ,Wang QD,Zhan MM.Age,gender,and hemispheric differences in iron deposition in the human brain:An in vivo MRI study[J].Neuro Image,2008(1):35-42.

文章评论(Comment)：