部分气味嗅觉识别障碍临床特点分析

Analysis of clinical characteristics of partial olfactory dysfunction

目的使用T＆T嗅觉计的不同嗅素识别阈测试法对患者嗅觉功能进行评估，并探讨部分嗅觉障碍的临床特点。方法2007年3月—2008年5月北京协和医院耳鼻咽喉科24例以嗅觉障碍为主诉患者的病历资料，通过病史、精神评估、耳鼻喉科常规检查、鼻窦CT检查，回顾性分析嗅觉障碍患者的病程、病因。T＆T嗅觉计由5种嗅素组成，分别测试T＆T嗅觉计总嗅觉识别阈以及每种嗅素的嗅觉识别阈，综合评估患者的嗅觉功能。结果本组24例嗅觉障碍患者，T＆T嗅觉计总嗅觉识别阈测试结果均正常，但仅对T＆T嗅觉计5种嗅素液中的1或2种嗅素存在嗅觉障碍，其中对“愉快气体”识别障碍占51．4％，对“非愉快气体”识别障碍占48．6％。结论部分嗅觉障碍是T＆T嗅觉计总嗅素识别阈正常、单嗅素识别阈升高为特征的嗅觉障碍形式。

Objective To apply different types and concentrations of T＆T olfactometer odorants to exam smell function and explore the clinical characteristics of partial olfactory dysfunction. Methods From March 2007 to May 2008, a total of 24 patients with olfactory dysfunction were examined by medical and psychiatric history enquiry, physical examination, smell testing and medical imaging. Olfactory function of each nostril was assessed separately by T＆T olfactometer. The test contained five kinds of odorants at different concentrations. Recognition threshold （RT） scores for all five odorants and for each individual odorant were measured in all patients. Results Among them, total RT scores were normal while single odorant testing yielded only significant higher RT scores for one or two odorants. For patients who suffered partial olfactory dysfunction, 51.4% are for pleasant odors, while the rest are for unpleasant odors. Conclusion Normal total RT scores and abnormal single RT scores of T＆T olfactometer are present in partial olfactory dysfunction. As a special clinical manifestation of olfactory disorder, it may be easily ignored in smell testing.