帕金森病患者的嗅觉功能评价及其影响因素

The olfactory function evaluation of Parkinson disease and its influencing factors

目的探讨帕金森病患者嗅觉障碍的发生率和特点及其可能的影响因素。方法采用12项气味识别能力测试(12 Item odor identification test from Sniffin’Sticks,SS-12)对106例帕金森病患者和110名正常志愿者进行嗅觉评估,比较两组的嗅觉功能,分析年龄、性别、文化程度、吸烟史、帕金森病病程、Hohn-Yahr分期、UPDRS-Ⅲ评分、左旋多巴用量与嗅觉的相关性。结果帕金森病组嗅觉得分(5.97±2.27)明显低于对照组(8.04±2.00),差异有统计学意义(P=0.000);帕金森病组对一些气味的识别(薄荷、香蕉、甘草、咖啡、菠萝、玫瑰、鱼)明显差于对照组(P<0.05);ROC曲线分析显示,7.5分是嗅觉障碍的最佳诊断界值,其敏感度为67.3%,特异度为73.6%,由此得出帕金森病组中嗅觉障碍的发生率为73.6%;相关性分析结果显示,帕金森病组性别(rs=-0.243)、文化程度(rs=0.208)及吸烟史(rs=-0.279,)与气味识别能力相关(P<0.05),而年龄、病程、Hohn-Yahr分期、UPDRS-Ⅲ评分及左旋多巴用量与气味识别能力不相关(P>0.05)。结论帕金森病患者嗅觉障碍发生率较高,帕金森病患者的嗅觉功能与疾病病程、Hohn-Yahr分期、UPDRS-Ⅲ评分及左旋多巴用量无关。

Objective To explore the incidence of olfactory dysfunction in patients with Parkinson disease and the characteristic as well as its possible influencing factors. Methods The SS-12 was used to evaluate the olfactory function of 106 patients with Parkinson＇s disease and 110 healthy volunteers. The data was then compared between the two groups to investigate the correlation of olfactory function with age, gender, education, smoking, disease duration, Hohn-Yahr stage, UPDRSⅢscores, the dosage of levodopao and olfactory scores. Results Mean identification scores were significantly lower in patients（5.97 ± 2.27）than in controls（8.04 ± 2.00）（t=7.108, P=7.108）. Parkinson＇s disease group did worse than the control group in identifying some odors including peppermint, bananas,liquorice,coffee,pineap-ple,rose and fish （P〈0.05）. Receiver Operating Characteristic curves revealed that 7.5 was the best olfactory dysfunc-tion diagnostic boundary value with 67.3%sensitivity and 73.6%specificity. Thus, the incidence of olfactory dysfunc-tion in Parkinson＇s disease was 73.6%. Correlation analysis showed that gender（rs=0.243, P=0.012）, education（rs=0.208, P=0.032） and smoking（rs=0.279, P=0.279） were associated with odor identification ability, while age, disease du-ration, Hohn-Yahr stage, UPDRSⅢscores and the dosage of levodopa were not related with odor identification abilityin Parkinson disease （P〉0.05）. Conclusion Olfactory dysfunction occurs in Parkinson disease with an hign incidence rate. Olfactory function has nothing to do with disease duration, Hohn-Yahr stage, UPDRSⅢscores and the dosage of levodopa in Parkinson disease.