Sniffin ’ Sticks 方法评价帕金森病患者的嗅觉功能  

Sniffin’ Sticks test in evaluating olfactory function in Parkinson’ s disease

作　　者：罗懿[1] 万赢[1] 干静[1] 胡荣郭 花芸[1] 刘振国[1] 瞿梦媛 沈炜娣[1] 魏雅荣[1] 任肖玉[1] 

机构地区：[1]上海交通大学附属新华医院神经内科,200092

出　　处：《中华神经科杂志》2014年第6期370-374,共5页Chinese Journal of Neurology

基　　金：上海市卫生局青年科研项目（2010Y049）;上海高校选拔培养优秀青年教师科研专项基金（jdy10111）;上海市级医院联合社区开展性病综合防治项目（SHDC12012320）

摘　　要：目的：选用Sniffin’ Sticks方法评价帕金森病患者的嗅觉功能情况及影响因素，比较Sniffin’ Sticks方法和味道识别在帕金森病识别方面的优劣性。方法采用Sniffin’ Sticks方法，比较68例帕金森病患者和76名健康志愿者的嗅觉功能，分析年龄、病程、统一帕金森病评分量表分值、Hoehn-Yahr （ H-Y）分级、认知功能水平（蒙特利尔认知评估量表）与嗅觉的相关性。结果（1） Sniffin’ Sticks方法显示，帕金森病组嗅觉障碍发生率为83.8％（57/68），高于对照组的21.1％（16/76）。帕金森病患者的嗅觉总分[（19.6±8.2）分]明显低于健康对照组[（31.0±5.8）分，t＝9.694，P＝0.000]，嗅觉阈值得分[（6.6±3.2）分]明显低于健康对照组[（10.7±2.3）分，t＝6.834， P＝0.000]、味道辨别得分[（6.6±3.3）分]明显低于健康对照组[（9.9±2.5）分，t ＝6.834，P ＝0.000]、16种味道识别得分[（6.8±2.4）分]也明显低于健康对照组[（10.3±1.9）分， t＝9.658，P＝0.000]。（2）在帕金森病与健康对照组识别方面，Sniffin’ Sticks 方法的敏感度是0.897，特异度是0.737（曲线下面积＝0.891），与16种味道识别方法相近，与嗅觉阈值和味道辨别相比占优。（3）帕金森病患者的嗅觉总分与认知功能呈正相关（r＝0.243，P＝0.046），与年龄、性别、病程、病情严重程度无关；健康对照组的嗅觉总分与年龄呈负相关（r＝-0.270，P＝0.018），与认知功能呈正相关（r＝0.281，P＝0.014）。结论帕金森病患者嗅觉障碍发生率较高，嗅觉功能受损较为全面；Sniffin’ Sticks方法在帕金森病患者嗅觉功能定量和定性分析方面优于16种味道识别。在帕金森病识别方面，两种方法均具有较高的敏感度和特异度。Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease （PD） recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks（SS-16） tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr （H-Y） rating, and cognitive function level （Montreal Cognitive Assessment） was analyzed.Results （1）The prevalence of olfactory dysfunction in PD group （83.3%） was significantly higher than that in control group （21.2%）.The Sniffin’ Sticks test showed that the odor threshold score （6.6 ±3.2, P=0.000）, odor discrimination score （6.6 ±3.3, P=0.000）, 16 kinds of odor identification score （6.8 ±2.4, P=0.000） in PD group were significantly lower than those in control group.（ 2 ） When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.（ 3 ） The olfactory score in PD group was positively correlated＆nbsp;with cognitive function （r=0.243, P=0.046）, and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age （r=-0.270, P=0.018）, but positively correlated with cognitive function （r=0.281, P=0.014）.Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

关 键 词：帕金森病 嗅觉 嗅觉障碍 感觉阈 气味 

分 类 号：R742.5[医药卫生—神经病学与精神病学]