嗅觉功能检查在帕金森病诊断中的应用

Olfactory function test in Parkinson＇ s disease

目的探讨帕金森病（Parkinson＇s disease，PD）患者的嗅觉功能改变特点。方法对37例临床确诊的50岁以上PD患者和95名年龄匹配的健康中老年人进行T＆T主观嗅觉识别阈测试和嗅觉事件相关电位（olfactory event related potentials，OERP）检查，比较其主观嗅觉识别阈和嗅觉事件相关电位P2潜伏期的差异。结果≥70岁的PD患者左、右侧鼻腔主观嗅觉识别阈分别为4．6±1．1、4．4±1．2，〈70岁PD患者左、右侧鼻腔主观嗅觉识别阈分别为3．9±1．7、4．0±1．7；≥70岁的对照组左、右侧鼻腔主观嗅觉识别阈分别为0．4±0．9、0．4±0．9，〈70岁对照组左、右侧鼻腔主观嗅觉识别阈分别为0．5±0．8、0．5±0．8；PD患者组的主观嗅觉识别阈明显高于对照组（t=15．246、15．378、8．664、8．776，P〈o．01）；≥70岁的PD患者左、右侧鼻腔OERPP2潜伏期分别为（734．9±143．2）、（696．1±165．9）ms，〈70岁的PD患者左、右侧鼻腔OERP P2潜伏期分别为（730．5±159．4）、（719．5±159．2）ms；〉170岁的对照组左、右侧鼻腔OERP P2潜伏期分别为（547．9±65．0）、（558．5±56．3）瑚，〈70岁的对照组左、右侧鼻腔OERP P2潜伏期分别为（523．3±61．9）、（526．8±62．0）ms，OERPP2潜伏期则明显长于对照组（t=-3．940、-3．750、-7．514、-8．205，P〈0．01）；同时PD患者组的主观嗅觉识别阈和OERP的异常率明显高于对照组。结论PD患者主观嗅觉识别阈测试和OERPP2潜伏期结果明显比对照组差，提示嗅觉功能减退是PD的重要临床表现；嗅觉功能检查可以作为PD筛查、诊断的参考指标。

Objective To study the olfactory function test in Parkinson＇ s disease （PD）, in order to promote the diagnosis of the PD. Methods Subjects included 95 middle-aged volunteers and 37 PD patients. A subjective olfactometry with T＆T olfactometer was performed in all volunteers and patients. Olfactory event related potentials with isoamyl acetate were obtained in all volunteers and patients. Results The T＆T olfactometer results for the 2 sides were 4. 6 ± 1.1,4.4 ± 1.2 in PD patients older than 70 years old and 3.9 ± 1.7, 4. 0 ± 1.7 in those, respectively; while the data were 0. 4 ± 0. 9,0. 4 ± 0. 9 in volunteers older than 70 years, were 0. 5 ±0. 8,0. 5 ±0. 8 younger than 70 years old. There was a significant difference in T＆T olfactometer results between PD and volunteers（t = 15. 246,15. 378,8. 664,8. 776, P 〈 0.01 ）. The P2 latencies were respectively （734. 9 ± 143.2）, （696. 1 ± 165.9） ms for the 2 sides in PD older than 70 years, and （730. 5 ± 159.4）, （719.5 ± 159. 2） ms in PD younger than 70 years;while they were （547.9 ± 65.0）, （558. 5 ±56. 3） ms, and （523.3 ±61.9）, （526. 8 ±62.0） ms in volunteers younger than 70 years. There was a significant difference in P2 latency between PD and volunteers （t = -3. 940, -3.750, -7.514, - 8. 205,P 〈 0. 01 ）. Conclusions Olfactory dysfunction is an important index in PD. Olfactory function test is an useful method in the diagnosis of PD.