帕金森病患者嗅觉减退的临床特点及影响因素分析  

Clinical features and influence factors of hyposmia in patients with Parkinson's disease

作　　者：汤海燕[1] 谈鹰[1] 冯颖 张冰[1] 王庄[1] TANG Haiyan;TAN Ying;FENG Ying;ZHANG Bing;WANG Zhuang(Department of Neurology,Huzhou Central Hospital,Affiliated Central Hospital Huzhou University,Huzhou 313000,China)

机构地区：[1]湖州市中心医院(湖州师范学院附属中心医院)神经内科,313000

出　　处：《浙江医学》2021年第3期290-293,共4页Zhejiang Medical Journal

基　　金：湖州市科技局公益性应用研究项目(2017GYB20)。

摘　　要：目的探讨帕金森病(PD)患者嗅觉减退的临床特点及影响因素。方法回顾性分析2019年2月至2020年5月在湖州市中心医院神经内科门诊及住院的PD患者84例,其中PD伴嗅觉减退组44例,PD不伴嗅觉减退组40例。比较两组患者统一PD评定量表第Ⅲ部分评分、Hoehn-Yahr(H-Y)分期、便秘、快速眼动期睡眠行为障碍(RBD)、焦虑、抑郁及认知障碍、血清尿酸、载脂蛋白A1及总谷胱甘肽的差异。采用Spearman等级相关分析PD患者嗅觉减退与其他非运动症状及血清生化指标之间的相关性,采用二分类logistic回归分析PD患者嗅觉减退的影响因素。结果PD伴嗅觉减退组患者便秘、RBD、焦虑和认知障碍发生率均高于PD不伴嗅觉减退组,血清总谷胱甘肽水平低于PD不伴嗅觉减退组,差异均有统计学意义(均P<0.05)。Spearman等级相关分析显示,PD患者嗅觉减退与便秘、RBD、焦虑、认知障碍发生率均呈正相关(r=0.290、0.285、0.241、0.342,均P<0.05)。二分类logistic回归分析发现认知障碍是PD嗅觉减退的影响因素(OR=13.449,95%CI:1.590~113.736,P<0.05)。结论PD伴嗅觉减退患者更易出现便秘、RBD、焦虑、认知障碍及低水平血清总谷胱甘肽,其中认知障碍是PD嗅觉减退的影响因素。Objective To investigate the clinical features and influence factors of hyposmia in patients with Parkinson's disease(PD).Methods Eighty-four PD patients attended in Neurology Department of Huzhou Central Hospital from February 2019 to May 2020 were recruited in this retrospective study.There were 44 PD patients with hyposmia and 40 patients without hyposmia.Hoehn-Yahr(H-Y)stage,unified Parkinson's disease rating scale(UPDRS)-Ⅲ,constipation,rapid eye movement sleep behavior disorder(RBD),anxiety,depression,cognitive impairment,serum uric acid(UA),apolipoprotein A1(ApoA1)and total glutathione(t-GSH)were compared between two groups.Spearman correlation assessed correlations between hyposmia and other non-motor symptoms(NMS),hyposmia and biochemical indicators.Multivariate logistic regression was applied to analyze the influence factors of hyposmia in PD patients.Results The frequency of constipation,RBD,anxiety and cognitive impairment in hyposmia group was significantly higher than that in non-hyposmia group(P<0.05),while the t-GSH level was lower than that in non-hyposmia group(P<0.05).Spearman correlation revealed that the hyposmia in PD patients was positively correlated with constipation,RBD,anxiety,and cognitive impairment(r=0.290,0.285,0.241,0.342,all P<0.05).Based on multivariate logistic regression analysis,the cognitive impairment was the independent risk factor for hyposmia in PD patients(OR=13.449,95%CI:1.590-113.736,P<0.05).Conclusion PD patients with hyposmia are significantly associated with constipation,RBD,anxiety,cognitive impairment and the lower level t-GSH.Cognitive impairment is an independent risk factor for hyposmia in PD patients.

关 键 词：帕金森病 嗅觉减退 快速眼动期睡眠行为障碍 认知障碍 谷胱甘肽 

分 类 号：R742.5[医药卫生—神经病学与精神病学]