The Utilization of Nuclear Medicine for Patients With Neurodegenerative Diseases in Taiwan

臺灣神經退化性疾病患者核醫使用分析

洪茂欽(Mao-Chin Hung) ； 蔡易橙(Yi-Cheng Tsai) ； 高志浩(Chih-Hao Kao) ； 吉彥婷(Yen-Ting Chi)

《核子醫學暨分子影像雜誌》 31卷2期 (2018/06) Pp. 67-74

https://doi.org/10.6332/ANMMI.201806_31(2).0002

摘要

Background: Neurodegenerative diseases such as dementia increase with population aging. Therefore, this study attempts to analyze the prevalence of these diseases and the trends in the use of nuclear medicine and radiopharmaceuticals. Methods: Using the National Health Insurance Research Database from 2002 to 2013, we conducted descriptive statistics on the utilization of nuclear medicine and medical expenditure for neurodegenerative diseases. Results: Between 2002 and 2013, the prevalence of dementia in Taiwan increased from 104 to 578 per 100,000 population, Alzheimer's disease increased from 13 to 51 and Parkinson's disease increased from 132 to 363. The use rate of nuclear medicine for dementia was constantly 10 per 1,000 population, for Alzheimer's disease increased from 21 to 28 per 1,000 population and increased from 24 to 40 per 1,000 population for Parkinson's disease. The most common examination was cerebral perfusion scintigraphy and the most commonly used radiopharmaceuticals was Tc-99m ethyl cysteinate dimer (ECD) for dementia and Alzheimer's disease. The most common test was Tc-99m TRODAT-1 single photon emission tomography (SPECT) and the most commonly used radiopharmaceuticals was Tc-99m TRODAT-1 for Parkinson's disease. About medical expenditure, an average of NT$ 5,730 for dementia, an average of NT$ 4,687 for Alzheimer's disease and an average of NT$ 6,706 for Parkinson's disease per year. Conclusions: The prevalence of neurodegenerative diseases increased in the past years in Taiwan. The utilization and expenditure of nuclear medicine for Parkinson's disease also increased significantly.

關鍵字

dementia ； Alzheimer's disease ； Parkinson's disease ； National Health Insurance Research Database (NHIRD) ； radiopharmaceuticals

並列摘要

背景：調查臺灣失智症等神經退化性疾病的盛行率，以及核子醫學檢查、核子醫學藥物的使用情形與變化趨勢。方法：使用2002年至2013年的全民健康保險研究資料庫，針對神經性退化疾病的核子醫學使用率及醫療費用進行描述性統計。結果：2002年至2013年間，臺灣失智症從每10萬人口104人上升至578人、阿茲海默症從13人增加至51人、巴金森氏症從132人上升至363人；在核子醫學檢查方面，使用率在失智症維持每千人口10人，阿茲海默症從21人上升至28人，巴金森氏症從24人上升至40人；失智症與阿茲海默症最常做的檢查為腦質斷層灌注掃描，最常使用的核子醫學藥物為Tc- 99m ethyl cysteinate dimer (ECD)；巴金森氏症最常做的檢查為Tc-99m TRODAT-1腦部多巴胺神經元斷層造影，最常使用的核子醫學藥物為Tc- 99m TRODAT-1；至於每人每年平均核子醫學健保支出，失智症為5,730元，阿茲海默症為4,687元，巴金森氏症為6,706元。 結論：臺灣失智症等神經退化性疾病之盛行率有逐年增加的趨勢，其中巴金森氏症患者的核子醫學使用率及健保支出有顯著增加的趨勢。

並列關鍵字

失智症 ； 阿茲海默症 ； 巴金森氏症 ； 全民健康保險研究資料庫 ； 核醫藥物