嗅觉检测对中国阿尔茨海默病和轻度认知功能障碍患者的诊断价值  

Diagnostic value of olfactory tests in patients with Alzheimer ’s disease and mild cognitive impairment in China

作　　者：郭文静 赵傲楠 闫艺 仇颖慧 邓钰蕾[1] GUO Wenjing;ZHAO Aonan;YAN Yi;QIU Yinghui;DENG Yulei(Encephalopathy Center,Shanghai Luwan Branch,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai200020,China;Department of Neurology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院脑病中心,上海200020 [2]上海交通大学医学院附属瑞金医院神经内科,上海200025

出　　处：《中国医药导报》2023年第2期60-64,共5页China Medical Herald

基　　金：科技部重点研发计划项目(2018YFC1312001);国家自然科学基金面上项目(82171400);上海市自然基金面上项目(19ZR1432500)。

摘　　要：目的 探讨嗅觉检测对阿尔茨海默病(AD)和轻度认知功能障碍(MCI)患者的诊断价值。方法 本研究为横断面研究,收集2016年6月至2019年10月就诊于瑞金医院神经内科的MCI患者75例、AD患者75例及健康受试者(HC组)50名;采用16项气味能力识别测试(SS-16)作为主要嗅觉评估工具,以该测试分数为指标评判受试者的嗅觉功能,通过量表评定其多个认知领域的认知功能,如记忆力、定向力、操作能力等。结果 AD组简易精神状态检查(MMSE)、蒙特利尔认知量表(MoCA)、SS-16评分低于HC组及MCI组,MCI组MMSE、Mo CA、SS-16评分低于HC组,差异有统计学意义(P<0.05)。AD组ADL评分高于HC组及MCI组,差异有统计学意义(P<0.05)。AD组橙子、皮革、肉桂、薄荷、香蕉、柠檬、甘草、蒜、咖啡、茴香、鱼的准确率低于HC组、MCI组,菠萝准确率低于HC组,MCI组肉桂、蒜准确率低于HC组,差异有统计学意义(P<0.05)。受试者操作特征曲线显示,区别AD与HC的气味识别评分截断值为10分,灵敏度为88%,特异度为74%。区别AD和MCI的截断值为8分,灵敏度为56%,特异度为90%。多元线性回归分析显示,年龄和MMSE分数是影响SS-16的相关指标(P<0.05)。结论 SS-16是中国AD患者嗅觉评估的一个有效工具,嗅觉障碍与MCI患者的认知功能下降有关。Objective To explore the diagnostic value of olfactory detection in patients with Alzheimer’s disease(AD) and mild cognitive impairment(MCI).Methods In this cross-sectional study,75 patients with MCI,75 patients with AD and 50healthy subjects(HC group) admitted to the Department of Neurology of Ruijin Hospital from June 2016 to October 2019were collected.The 16-item odor identification test from sniffin sticks(SS-16) was used as the main olfactory evaluation tool.The score of the test was used as the index to evaluate the subjects’ olfactory function,and the cognitive function in various cognitive fields,such as memory,orientation and operational ability,was assessed by the scale.Results The scores of mini mental state examination(MMSE),Montreal cognitive scale(Mo CA),and SS-16 in AD group were lower than those in HC and MCI group,while the scores of MMSE,Mo CA,and SS-16 in MCI group were lower than those in HC group,and the differences were statistically significant(P<0.05).The ADL score in AD group was higher than that in HC group and MCI group,and the differences were statistically significant(P<0.05).The accuracy of orange,leather,cinnamon,mint,banana,lemon,licorice,garlic,coffee,fenise,and fish in AD group were lower than that in HC and MCI groups;the accuracy of pineapple was lower than that in HC group;the accuracy of cinnamon and garlic in MCI group was lower than that in HC group,and the differences were statistically significant(P <0.05).Receiver operating characteristic curve showed that the cut-off value of odor recognition score between AD and HC was 10 scores,the sensitivity was 88%and the specificity was 74%.The cut-off value of AD and MCI was 8 scores,the sensitivity was 56%,and the specificity was90%.Multiple linear regression analysis showed that age and MMSE score were related to SS-16(P<0.05).Conclusion SS-16 is an effective tool for olfactory assessment in Chinese patients with AD,and anosmia is related to cognitive decline in patients with MCI.

关 键 词：阿尔茨海默病 轻度认知功能障碍 嗅觉障碍 嗅棒 

分 类 号：R741.04[医药卫生—神经病学与精神病学]