不同维度嗅觉测试在帕金森病患者中的应用价值及与快速眼动睡眠行为障碍的相关性  

Multidimensional evaluation of olfactory function in patients with Parkinson′s disease and its correlation with rapid eye movement sleep behavior disorder

作　　者：王梦奇 陈芯 赵子晔 胡丽丽 朱旻昊 程静静 胡盼盼[1,2] Wang Mengqi;Chen Xin;Zhao Ziye;Hu Lili;Zhu Minhao;Cheng Jingjing;Hu Panpan(School of Mental Health and Psychological Science,Anhui Medical University,Hefei,230032,China;Department of Neurology,the First Affiliated Hospital of Anhui Medical University,Hefei,230022,China)

机构地区：[1]安徽医科大学精神卫生与心理科学学院,合肥230032 [2]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《中华医学杂志》2025年第9期694-700,共7页National Medical Journal of China

基　　金：国家自然科学基金(82171917、82471271);结合觉和认知功能的阿尔茨海默病早期筛查及干预的示范基地建设(E1CX067003)。

摘　　要：目的分析不同维度嗅觉测试在帕金森病(PD)患者中的应用价值,探讨PD患者伴和不伴快速眼动睡眠行为障碍(RBD)的不同嗅觉维度的临床特点及不同嗅觉维度与RBD的相关性。方法回顾性纳入2023年5月至2024年6月就诊于安徽医科大学第一附属医院神经内科的患者共73例,根据快速眼动睡眠行为障碍筛查量表(RBDSQ)将PD患者分为PD伴RBD(PD-RBD+)25例,PD不伴RBD(PD-RBD-)48例。招募同期患者家属作为健康对照,共39名。所有被试均收集一般资料,评估运动症状、情绪、睡眠状态及认知功能,采用嗅觉阈值、分辨和识别三个维度的嗅觉测试评估嗅觉功能。采用受试者工作特征(ROC)曲线分析三个嗅觉测试区分PD患者和健康对照的能力。采用Spearman相关分析评估不同嗅觉维度与运动及非运动症状间的相关性。结果PD患者男39例,女34例,年龄(63±7)岁;健康对照男16名,女23名,年龄(64±10)岁。PD患者的嗅觉阈值[(6.92±4.20)分比(9.36±4.33)分]、分辨[(7.44±3.05)分比(10.44±3.04)分]和识别[(15.38±5.80)分比(22.72±5.09)分]得分均低于健康对照组(均P<0.05)。不同嗅觉测试区分PD患者和健康对照的ROC曲线分析显示,在三种嗅觉测试中,嗅觉阈值测试的曲线下面积(AUC)为0.671(95%CI:0.568~0.773),嗅觉分辨测试的AUC为0.750(95%CI:0.655~0.844),嗅觉识别测试的AUC为0.829(95%CI:0.751~0.906)。PD-RBD+组的嗅觉识别低于PD-RBD-组[(13.36±5.77)分比(16.44±5.58)分,P=0.030],PD-RBD+组的嗅觉阈值[(6.58±3.49)分比(6.69±4.04)分]和分辨[(7.00±3.39)分比(7.00±3.39)分]与PD-RBD-组差异均无统计学意义(均P>0.05)。嗅觉阈值与蒙特利尔认知评估量表(MoCA)评分呈正相关(r=0.236);嗅觉分辨与匹兹堡睡眠量表(PSQI)评分呈负相关(r=-0.347);嗅觉识别与MoCA呈正相关(r=0.246),与RBDSQ(r=-0.254)、PSQI(r=-0.335)呈负相关(均P<0.05)。结论PD患者的嗅觉阈值、分辨和识别的能力均存在损害,嗅觉识别测试区分Objective To analyze the application value of different dimensional olfactory tests in different dimensions of olfactory function in patients with Parkinson′s disease(PD),and to explore the clinical characteristics of different olfactory dimensions in PD patients with and without rapid eye movement sleep behavior disorder(RBD)and the correlation between different olfactory dimensions and RBD.Methods A total of 73 patients who visited the Department of Neurology,the First Affiliated Hospital of Anhui Medical University from May 2023 to June 2024 were retrospectively included.According to the Rapid Eye Movement Sleep Behavior Disorder Screening Scale(RBDSQ),PD patients were divided into 25 cases of PD with RBD(PD-RBD+)and 48 cases of PD without RBD(PD-RBD-).A total of 39 family members of patients in the same period were recruited as healthy controls.General data of all subjects were collected,and their motor symptoms,emotions,sleep status and cognitive function were evaluated.Olfactory function was evaluated by olfactory threshold,discrimination and recognition olfactory tests in three dimensions.The receiver operating characteristic(ROC)curve was used to analyze the ability of the three olfactory tests to distinguish PD patients from healthy controls..Spearman correlation analysis was used to evaluate the correlation between different olfactory dimensions and motor and non-motor symptoms.Results There were 39 males and 34 females in PD patients,aged(63±7)years old;there were 16 males and 23 females in healthy controls,aged(64±10)years old.The olfactory threshold[(6.92±4.20)vs(9.36±4.33),P=0.005],discrimination[(7.44±3.05)vs(10.44±3.04),P<0.001]and recognition[(15.38±5.80)vs(22.72±5.09),P<0.001]scores of PD patients were lower than those of healthy controls.ROC curve analysis of different olfactory tests to distinguish PD patients from healthy controls showed that among the three olfactory tests,the area under the curve(AUC)of the olfactory threshold test was 0.671(95%CI:0.568-0.773,P=0.003),the AUC of t

关 键 词：帕金森病 嗅觉障碍 嗅觉识别 快速眼动睡眠行为障碍 横断面研究 

分 类 号：R74[医药卫生—神经病学与精神病学]