中文摘要：

目的探讨质子磁共振波谱（^1H-MRS）研究非痴呆性帕金森病患者海马的代谢变化及临床应用价值。方法对36例非痴呆性帕金森病患者（Hoehn-Yahr分级为Ⅰ级14例、Ⅱ级8例、Ⅲ级8例、Ⅳ级6例）和20例年龄匹配的正常对照者双侧海马进行^1H-MRS检测，对比分析帕金森病患者与正常对照者的海马N-乙酰基天门冬氨酸（NAA）／肌酸复合物（Cr）和含胆碱化合物（Cho）／Cr比值的变化。结果Hoehn-YahrⅣ级帕金森病患者双侧海马的NAA／Cr比值均低于正常对照者（P〈0．05），Cho／Cr比值均高于正常对照者（P〈0．05）；但Hoehn-YahrⅠ～Ⅲ级帕金森病患者双侧海马的NAA／Cr和Cho／Cr比值较正常对照者无明显变化（P〉0．05）。结论^1H-MRS能够发现Hoehn-YahrⅣ级非痴呆性帕金森病患者海马的代谢变化，间接反映其神经细胞病理学改变，有助于帕金森病痴呆发生风险的预测。

英文摘要：

Objective To explore the clinical application value of proton magnetic resonance spectroscopy （^1H-MRS） in the metabolism of the hippocampus in non-demented Parkinson＇s disease（PD） patients. Methods ^ 1H-MRS localized to both hippocampus, was carried out in 36 non-demented PD （ 14 patients with Hoehn-Yabr stage I ,8 patients with Hoehn-Yahr stage 11,8 patients with Hoehn-Yahr stage Ill, and 6 patients with Hoehn-Yahr stageIV） and 20 age-matched healthy control subjects. The metabolite ratios of N-acetylasparatate （NAA ）/creatine （ Cr） ,and choline-containing compounds（ Cho）/Cr in PD patients were compared with those in the age-matched healthy control subjects. Results NAA/Cr ratios were reduced significantly and Cho/Cr ratios were increased significantly in both hippocampus of patients with Hoehn-Yahr stage IV compared to those in the age-matched healthy control subjects （ P 〈0.05）. However,no significant differences in NAA/Cr and Cho/Cr ratios were found between patients with Hoehn-Yahr stage Ⅰ -Ⅲ and the age-matched healthy control subjects （ P 〉 0.05 ）. Condusion ^1 H- MRS can provide the metabolic information, and reflect the pathological changes of nerve cell in the hippocampus of non-demented PD patients with Hoehn-Yabr stage IV. It is helpful to predict the risk of dementia in PD.