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目的 探讨伴认知功能障碍帕金森病(Parkinson’s discase,PD)的脑葡萄糖代谢特征和变化过程,寻求PD认知相关的新型生物学标志物.方法 将临床诊断为原发性帕金森病患者50例进行MMSE评分,分为25例认知功能正常组(PD-NC)、25例伴认知障碍组(PDD),20例年龄、性别匹配的健康体检者作为对照组(control).3组均进行脑葡萄糖代谢显像(18F-FDG-PET)并应用统计参数图(SPM)进行数据分析,比较各组间脑内葡萄糖代谢变化的差异和特点.结果 (1)1与对照组比较,PD-NC组出现枕叶(-24,-92,10)、顶叶(52,8,-32)、颞叶(-48,12,-16)代谢减低.(2)与对照组比较,PDD组出现广泛皮质(额、顶、颞、枕、边缘叶)代谢减低.(3)PDD组与PD-NC组相比,顶叶(-42,-48,40)、枕叶(-22,-96,-6)、颞叶(-42,-58,16)出现代谢减低加重.结论 PD-NC组已经出现大脑皮质代谢减低,随着PD认知功能障碍的进展,PD患者出现葡萄糖代谢减低的范围逐渐扩大,代谢减低的程度逐渐增加.这些特征有助于帕金森病伴认知功能障碍的诊断和鉴别诊断.“,”Objective To investigate the change of the cerebral glucose metabolism in Parkinson’s disease(PD) with cognitive impairment.Methods Fifty patients with PD and twenty normal controls were enrolled in this study.Based on MMSE score,the PD patients were divided into PD-NC(n=25) and the PDD(n=25) group.Twenty age-and sex-matched physical health examinationer were colleted as control group.Using the SPM to analyze the characteristics of the metabolism in different cognitive level io PD patients.Results (1) Compared with control group,P D-NC group showed significant hypermetabolism in occipital (-24,-92,10),parietal (-48,12,-16) and temporal lobe(52,8,-32).(2)Compared with control group,the glucose metabolism of PDD group decreased in most cerebral cortex and subcortex.(3)Compared with PD-NC group,the metabolism of parietal lobe (-42,-48,40),occipital lobe (-22,-96,-6) and tetnporal lobe (-42,-58,16) reduced in PDD group.Conclusion Cortical brain metabolism decreases in PD-NC group.The degree and scope of glucose metabolism of PDD group will increase with the progress of cognitive dysfunction.These features could help with the diagnosis and differential diagnosis of cognitive dysfunction in Parkinson’s disease.