再来,仔细看下面这一段(摘自上贴的同一篇文章)
In our study, most of the patients with DIP (90%) had cardiac MIBG uptake within the normal range, suggesting that they did not have the sympathetic dysfunction seen in Parkinson’s disease, and that their DIP may be unrelated to Parkinson’s disease. However, two patients with DIP (10% of the DIP group) showed markedly low cardiac MIBG uptake, falling into the range of Parkinson’s disease patients. As in the study by Burns and Brooks,9 the two patients with low cardiac MIBG uptake had persistent parkinsonism after the offending drug was withdrawn, and both patients responded dramatically to levodopa. Thus it is speculated that in these patients the offending drugs may have aggravated the potential dopaminergic defect and thus unmasked the clinical manifestation of Parkinson’s disease.
Various drugs have been reported to influence cardiac MIBG uptake.11 Haloperidol decreases MIBG uptake at very highly concentration, however—which is far above that achieved therapeutically.16 Cilnidipine, third generation dihydropyridine based calcium antagonist, is reported to enhance cardiac MIBG uptake and this would lead to falsely raised values; however, this effect is likely to be minimal because the increase in the H/M ratio after cilnidipine treatment is very slight (~0.1).17 Chlorpromazine and perphenazine might be expected to interfere with cardiac MIBG uptake11; however, there was no direct evidence of this. Finally, there are no reports of drug interactions between levosulpiride, metoclopramide, or risperidone and MIBG. Thus we believe that in present study the influence of the offending drugs on the MIBG uptake was likely to have been trivial.Because the number of offending drugs was small, however, we were unable to show in this study whether DIP patients without preclinical Parkinson’s disease all have a normal MIBG uptake or not.
Compared with F‐dopa PET, 123I‐MIBG myocardial scintigraphy is more widely available, requires less sophisticated equipment and analytic procedures, and is cheaper. Our study suggests that cardiac MIBG uptake is in the normal range in a majority of patients with DIP, suggesting that in these patients the condition is unrelated to Parkinson’s disease. However, cardiac MIBG uptake can be abnormal in some patients with DIP and in these cases the disorder is clinically similar to Parkinson’s disease.