原发性帕金森病患者嗅觉功能临床分析  

Olfactory function in patients with idiopathic Parkinson＇s disease

作　　者：杭伟[1] 刘钢[1] 韩彤[2] 张佩兰[3] 张金玲[1] 

机构地区：[1]天津市环湖医院耳鼻咽喉头颈外科,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》2015年第1期20-24,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 分析原发性帕金森病患者嗅球体积、嗅沟深度与嗅觉功能的相关性.方法 选取2011年1月至2013年12月天津市环湖医院原发性帕金森病患者（测试组）及无运动障碍的健康受试者（对照组）各100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检查及测量.对测试组进行H-Y分期、统一帕金森病评分量表（UPDRS）、左右肢体功能评分、简易精神状态检查表（MMSE）及蒙特利尔认知评估表（MoCA）检查.以SPSS 13.0软件进行统计学分析.结果 测试组T＆T嗅觉识别阈分数为（3.0±0.3）分,明显高于对照组的（1.3±0.2）分,差异有统计学意义（t=2.537,P＜0.01）,测试组、对照组男女嗅觉识别阈差异无统计学意义（t值分别为0.893、1.184,P值均＞0.05）.测试组左右两侧嗅球体积[分别为（34.25 ±5.14）、（35.79±5.28）mm3]及平均嗅球体积[（35.28±5.21） mm3]均明显小于对照组[分别为（47.38±6.47）、（47.75 ±6.51）、（47.53±6.49）mm3],差异有统计学意义（t值分别为2.876、2.747、2.798,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0.914、0.987、0.951,P值均＞0.05）.测试组及对照组嗅觉识别阈与平均嗅球体积呈负相关趋势（r值分别为-0.537、-0.526,P值均＜0.05）,与平均嗅沟深度无关（r值分别为-0.142,-0.157,P值均＞0.05）.测试组平均嗅球体积与UPDRSⅢ、UPDRS总评分及H-Y分期具有相关趋势（r值分别为0.312、-0.419、-0.358,P值均＜0.05）,与病程无相关性（r=-0.089,P＞0.05）.结论 原发性帕金森病患者嗅球体积减小,嗅沟深度不变;其嗅觉功能与嗅球体积具有相关性,与嗅沟深度无关;其嗅觉减退的程度与疾病的严重程度具有一致性,与疾病的病程无关.Objective To analyze the correlation between olfactory bulb（OB） volume with depth of olfactory sulcus（OS） and olfactory function in patients with idiopathic Parkinson＇s disease （IPD）.Methods One hundred patients with IPD between January 2011 to December 2013 in Tianjin Huanhu Hospotal were compared with one hundred controls in terms of olfactory function T＆T testing,OB volume and depth of OS assessed with Magnetic resonance imaging （MRI）.One hundred IPD patients were investigated and estimated H-Y degrees,UPDRS,MMSE,MoCA.SPSS 13.0 software was used to analyze the data.Results T＆T olfactory testing revealed that IPD patients （3.0 ± 0.3） had higher scores than controls（1.3 ± 0.2,t =2.537,P＜0.01）.Both men and women with IPD were affected by the same extent of olfactory loss（t =0.893,P ＞ 0.05）.Both men and women as controls were affected by the same extent of olfactory loss（t =1.184,P ＞ 0.05）.OB volume of left side in IPD patients was （34.25 ± 5.14） mm3,right side was （35.79 ±5.28）mm3,average OB volume was （35.28 ±5.21）mm3 ; OB volume of left side in controls was （47.38 ± 6.47） mm3,right side was （47.75 ± 6.51） mm3,average OB volume was （47.53 ± 6.49）mm3 ; OB volume were lower in IPD patients as compared to controls（t value were 2.876,2.747,2.798,all P ＜ 0.01）.OS depth study revealed no statistical difference between IPD patients and controls （t value were 0.914,0.987,0.951,all P ＞ 0.05）.Olfactory discriminate threshold was negatively correlated with average OB volume in IPD patients and controls（r value were-0.537,-0.526,both P ＜ 0.05） ; was no correlated with average depth of OS（r value were-0.142,-0.157,both P ＞ 0.05）.There was relation between the average OB volume and UPDRS Ⅲ,UPDRS,the degree of H-Y in IPD patients（r value were 0.312,-0.419,-0.358,all P ＜0.05）.However the average OB volume was not related to the course of disease（r =-0.089,P ＞ 0.05）.Conclusions The OB volume is lower in IPD patients

关 键 词：帕金森病 嗅觉障碍 嗅球 嗅通路 磁共振成像 

分 类 号：R742.5[医药卫生—神经病学与精神病学]