嗅觉功能测查联合磁共振嗅球容积测定对阿尔茨海默病的早期诊断价值

Early diagnostic value of olfactory function measurement combined with MRI olfactory bulb volume measurement to Alzheimer's disease

目的:探讨嗅觉功能测查联合磁共振嗅球容积测定对阿尔茨海默病(AD)的早期诊断价值.方法:用图片介导的气味识别试验分别测定21例AD患者及21例正常对照者的嗅觉觉察阈、嗅觉识别阈;磁共振方法分别测定两组的海马体积及嗅球容积.结果:AD组嗅觉减退,与正常对照组相比,差异有统计学意义(P<0.05).AD组简易智能状态检查(MMSE)总分与嗅觉察觉阈、嗅觉识别阈之间呈负相关(r=-0.50,r=-0.54,P<0.01).AD组海马体积较正常对照组明显减少,两组比较差异有统计学意义(P<0.01).AD组海马体积与MMSE评分呈正相关(r=0.45,P<0.05).AD组嗅球容积实测值及经颅腔容积校正值均较正常对照组缩小(P<0.01),AD组嗅球容积与海马体积、MMSE评分呈正相关(r=0.72,P<0.01;r=0.50,P<0.05),与嗅觉察觉阈及嗅觉识别阈呈负相关(为r=-0.63,r=-0.54,P<0.05).结论:嗅觉功能测查联合磁共振嗅球容积测定可帮助诊断早期AD.

AIM： To study the early diagnostic value of olfactory function measurement combined with MRI olfactory bulb volume measurement to Alzheimer＇s disease （ AD ）. METHODS ： Olfactory function measurement with picture-based odor identification test was conducted in 21 patients with AD and 21 healthy elderly subjects as control. Olfactory bulb volume and hippocampal volume in the two groups were measured with MRI. RESULTS： Olfactory function was significantly impaired in AD group compared with that in healthy control group （P 〈 0.05 ）. The total scores of mini-mental state examination（MMSE） in AD group were negatively correlated with the olfactory detectability threshold and olfactory identification threshold（r = -0.50, r = -0.54, P 〈0.01 ）. The hippocampal volume in AD group was significantly atrophic compared with that in controls（P 〈0.01 ） and a positive correlation in AD group was found between hippocampal volume and MMSE scores （ r = 0.45 ,P 〈 0.05 ）. The olfactory bulb volume significantly shrunk compared with that in control（P 〈0.01 ）. In AD group, olfactory bulb volume was positively correlated with hippocampal volume and MMSE scores （ r = 0.72, P 〈 0.01 ; r = 0.50, P 〈 0.05 ）, but negatively with olfactory detectability threshold and olfactory identification threshold （ r = - 0.63, r = - 0.54, P 〈 0.05）. CONCLUSION： Olfactory function measurement combined with MRI olfactory bulb volume measurement are of high early diagnostic value to Alzheimer＇ disease.