帕金森病患者的嗅觉功能、嗅球体积、嗅沟深度变化及诊断价值

Olfactory function,olfactory bulb volume,olfactory sulcus depth changes and related diagnostic value in patients with Parkinson's disease

目的探讨帕金森病(PD)患者嗅觉功能、嗅球体积、嗅沟深度变化,并分析其临床诊断价值。方法前瞻性将2016年8月至2018年7月收治的50例PD患者作为观察组,并将50例健康人作为对照组。比较两组嗅觉识别阈值(IT),并采用磁共振成像(MRI)检测其嗅球体积、嗅沟深度,并分析嗅觉功能与嗅球体积、嗅沟深度的相关性,探讨其对PD的诊断效能。结果观察组IT大于对照组(P <0. 05),嗅球体积小于对照组(P <0. 05),嗅沟深度与对照组无显著差异(P> 0. 05)。H&Y分级II级和III级PD患者嗅球体积小于I级(P <0. 05),IT大于I级(P <0. 05),嗅沟深度均无显著差异(P> 0. 05)。PD患者嗅觉功能与嗅球体积呈负相关(P <0. 05),与嗅沟深度无相关性(P> 0. 05)。IT、嗅球体积诊断PD截断点分别为1. 28分、39. 65 mm^3,诊断灵敏度分别为60. 39%、67. 45%,特异度分别为97. 10%、95. 73%。结论 PD患者嗅球体积减小,IT较大,嗅觉功能减退,且嗅觉功能与嗅球体积存在正相关性,两者可作为PD早期诊断重要评价指标。

Objective To investigate changes of olfactory function,olfactory bulb volume and olfactory sulcus depth in patients with Parkinson's disease(PD)and analyze its clinical diagnostic value.Methods 50 patients with PD in our hospital from August 2016 to July 2018 were into observation group.Another 50 healthy subjects who underwent physical examination in our hospital were into control group.Olfactory recognition threshold(IT)were compared.Volume of olfactory bulb and depth of olfactory sulcus were detected by MRI imaging.The correlation between olfactory function,olfactory bulb volume,olfactory sulcus depth was analyzed.The diagnostic efficiency regarding PD was discussed.Results The observation group had higher IT(P<0.05),less olfactory bulb volume(P<0.05)while similar olfactory sulcus depth compared with control group(P >0.05).The olfactory bulb volume of PD patients with H&Y grade II and III had less olfactory bulb volume(P<0.05),higher IT(P<0.05)while similar olfactory sulcus depth(P >0.05)than those with grade I.There was a positive correlation between olfactory function and olfactory bulb volume in PD patients(P<0.05).Olfactory function had no significant correlation with olfactory sulcus depth(P >0.05).Diagnostic cut-offs were 1.28 points and 39.65 mm 3 for IT and olfactory bulb volume,respectively,with diagnostic sensitivities of 60.39% and 67.45%,specificities 97.10% and 95.73%.Conclusion PD patients tend to have less olfactory bulb volume and higher IT,indicating decreased olfactory function.Olfactory function and olfactory bulb volume are positively correlated,both performing as nice diagnostic indexes for PD.