轻度认知障碍患者嗅觉功能的研究  

Olfactory function in patients with mild cognitive impairment

作　　者：杭伟[1] 刘钢[1] 韩彤[2] 周玉颖[3] 张金玲[1] 张强[1] 

机构地区：[1]天津市环湖医院耳鼻咽喉科,300060 [2]天津市环湖医院放射科,300060 [3]天津市环湖医院神经内科,300060

出　　处：《中华耳鼻咽喉头颈外科杂志》2014年第9期738-742,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：天津市卫生局科技基金项目（09KY18）;天津市卫生局攻关课题（12KG115）

摘　　要：目的 分析轻度认知障碍患者嗅球体积、嗅沟深度与嗅觉功能的相关性.方法 选取轻度认知障碍患者（测试组）及无认知障碍的健康受试者（对照组）各50例,应用T＆T嗅觉测试法检查所有受试者的嗅觉功能,并行嗅球体积、嗅沟深度的MRI检查.以简易精神状态检查表（MMSE）、蒙特利尔认知评估表（MoCA）、日常生活活动量表（ADL）检测评估认知障碍.以SPSS 13.0软件进行统计学分析.结果 测试组T＆amp;T嗅觉识别阈分数明显高于对照组,差异有统计学意义（t=3.142,P＜0.05）.测试组男女嗅觉识别阈差异无统计学意义（t=0.973,P＞0.05）,对照组男女嗅觉识别阈差异无统计学意义（t=1.092,P＞0.05）.测试组左右两侧嗅球体积、平均嗅球体积[分别为（36.35±4.09）、（36.57±4.13）、（36.47±4.12） mm3]均明显小于对照组[分别为（46.65±6.23）、（46.83±6.27）、（46.71±6.25）mm3],差异有统计学意义（t值分别为3.113、3.145、3.132,P值均＜0.01）.测试组与对照组左右两侧嗅沟深度及平均嗅沟深度差异无统计学意义（t值分别为0.876、0.952、0.904,P值均＞0.05）.测试组及对照组嗅觉识别阈与嗅球体积呈负相关趋势（r值分别为-0.643,-0.541,P值均＜0.05）,与嗅沟深度无关（r值分别为-0.167,-0.183,P值均＞0.05）.测试组嗅觉识别阈与MMSE、MoCA、ADL呈负相关趋势（r值分别为-0.427,-0.418,-0.399,P值均＜0.05）,测试组平均嗅球体积与MMSE、MoCA、ADL呈正相关趋势（r值分别为0.364,0.383,0.379,P值均＜0.05）.结论 轻度认知障碍患者嗅球体积减小,嗅沟深度不变;嗅觉功能与嗅球体积具有相关性,与嗅沟深度无关;认知障碍的严重程度与嗅觉减退的程度具有一致性;嗅觉功能减退可作为轻度认知功能障碍患者早期客观诊断的参考指标.Objective To analyze the correlation between olfactory bulb （OB） volume,depth of olfactory sulcus （OS） and olfactory function in patients with mild cognitive impairment （MCI）.Methods Fifty patients with MCI were compared with fifty controls in terms of olfactory function T＆T testing,OB volume and depth of OS assessed with magnetic resonance imaging （MRI）.SPSS 13.0 software was used to analyze the data.Results T＆T olfactory testing revealed that MCI patients had higher scores than controls （t =3.142,P 〈0.05）.Both men and women with MCI were affected by the same extent of olfactory loss（t =0.973,P 〉0.05）.Both men and women as controls were affected by the same extent of olfactory loss（t =1.092,P 〉 0.05）.OB volume of left side in MCI patients was （36.35 ± 4.09）mm3,right side was （36.57 ±4.13）mm3,average OB volume was （36.47 ±4.12）mm3 ; OB volume of left side in controls was （46.65 ± 6.23） mm3,right side was （46.83 ± 6.27） mm3,average OB volume was （46.71 ± 6.25）mm3 ; OB volumes were lower in MCI patients as compared with controls（t value was 3.113,3.145 and 3.132,allP 〈0.01）.OS depth study revealed no statistical different between MCI patients and controls（t value was 0.876,0.952 and 0.904,all P 〉 0.05）.Olfactory discriminate threshold was negatively correlated with OB volume in MCI patients and controls（r value was-0.643,-0.541,both P 〈0.05） ; was no correlated with depth of OS （r value was-0.167 and-0.183,both P 〉 0.05）.Olfactory discriminate threshold was negatively correlated with cognitive impairment degree in MCI patients（r value was-0.427,-0.418 and-0.399,all P 〈 0.05）,average OB volume was positively correlated with cognitive impairment degree in MCI patients（r value was 0.364,0.383 and 0.379,all P 〈0.05）.Conclusions The OB volumes are lower in MCI patients as compared with controls,the depth of OS show no significant changes in MCI patients.The OB volume is correlated with olfactory function,the depth of

关 键 词：嗅觉障碍 嗅通路 嗅沟 认知障碍 阿尔茨海默病 磁共振成像 

分 类 号：R749.1[医药卫生—神经病学与精神病学]