帕金森病痴呆和路易体痴呆在11C-PIB PET/CT脑显像及脑脊液检测中的差异分析

Analysis of the differences between Parkinsons disease dementia and dementia with Lewy bodies in 11C-PIB PET/CT brain imaging and cerebrospinal fluid test

    摘要
  • 摘要:
    目的 通过11C-匹兹堡化合物B（PIB）PET/CT显像及脑脊液中不同蛋白的检测，分析帕金森病痴呆（PDD）和路易体痴呆（DLB）患者在影像学和生物标志物方面的差异。
    方法 选取2011年6月至2018年2月已被临床诊断为PDD患者10例（PDD组），其中男性6例、女性4例，年龄57~79（69.90±6.57）岁；DLB患者11例（DLB组），其中男性6例、女性5例，年龄62~80（71.09±5.65）岁。使用11C-PIB PET/CT进行脑扫描，分别测定额叶、顶叶、颞叶、枕叶、丘脑、纹状体与小脑的平均标准化摄取值（SUVmean）的比值。采用双抗夹心酶联免疫吸附法测定脑脊液中tau蛋白、β淀粉样蛋白42（Aβ42）和丛生蛋白的浓度。2组患者不同脑区相对于小脑的SUVmean比值、脑脊液不同蛋白水平的比较，均采用t检验。
    结果 DLB患者各脑区相对于小脑的11C-PIB SUVmean的比值均高于PDD患者，且2组在额叶（DLB组：1.52±0.28，PDD组：1.21±0.25）、纹状体（DLB组：1.46±0.26，PDD组：1.20±0.21）之间的差异有统计学意义（t=−2.596、−2.504，P=0.018、0.022）。DLB组的tau蛋白水平（582.7±304.50） ng/L高于PDD组（344.10±133.37 ） ng/L，而Aβ42、丛生蛋白的水平（491.73±136.54） ng/L、（5219.45±1999.10） μg/L均低于PDD组（644.70±311.77） ng/L、（8358.30±3014.51） μg/L，且2组之间tau蛋白和丛生蛋白的水平差异均有统计学意义（t=−2.283、2.838，P=0.034、0.011）。
    结论 PDD和DLB在11C-PIB PET/CT脑显像及脑脊液检测中存在多项明显差异，可为临床的鉴别诊断提供依据。

     

    Abstract:
    Objective To analyze differences in the imaging and biomarkers of patients with Parkinson disease dementia(PDD) and those with dementia with Lewy bodies(DLB) by 11C-pittsburgh compound B(PIB) PET/CT imaging and testing of different proteins in the cerebrospinal fluid.
    Methods A total of 10 PDD patients(PDD group) including six males and four females, aged 57–79 years(mean, 69.9±6.57 years) and 11 DLB patients(DLB group) including six males and five females, aged 62–80 years(mean, 71.09±5.65 years), clinically diagnosed from June 2011 to February 2018 were recruited to this study. Brain scans were performed using 11C-PIB PET/CT to measure the mean standardized uptake value(SUVmean) ratios of the frontal lobe, parietal lobe, temporal lobe, occipital lobe, thalamus, and striatum to cerebellum. The concentrations of tau, amyloid β-protein42(Aβ42), and cluster proteins in the cerebrospinal fluid were determined by double-antibody sandwich enzyme-linked immunosorbent assay. T test was used to compare the SUVmean ratio of different brain regions to that of the cerebellum, as well as the protein levels of cerebrospinal fluid between the two groups.
    Results The ratio of 11C-PIB SUVmean in each brain region relative to that in the cerebellum was higher in DLB patients than in PDD patients, and differences between the two groups in the frontal lobe(DLB group: 1.52±0.28, PDD group: 1.21±0.25) and striatum(DLB group: 1.46±0.26, PDD group: 1.20±0.21) were statistically significant(t=–2.596, –2.504, P=0.018, 0.022). Tau levels in the DLB group(582.7±304.50) ng/L were higher than those in the PDD group(344.10±133.37) ng/L; by contrast, levels of Aβ42 and cluster proteins(491.73±136.54) ng/L, (5219.45±1999.10) μg/L in the DLB group were lower than those in the PDD group(644.70±311.77) ng/L, (8358.30±3014.51) μg/L. Tau and cluster proteins showed statistically significant differences between the two groups(t=–2.283, 2.838, P=0.034, 0.011).
    Conclusion PDD and DLB show many obvious differences during 11C-PIB PET/CT brain imaging and cerebrospinal fluid testing, and these differences can provide a basis for clinical differential diagnosis.

     

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