应用Sniffin′嗅棒方法评价新疆维吾尔自治区阿尔茨海默病病人的嗅觉功能及其影响因素

Evaluation of Olfactory Function in Patients with Alzheimer′s Disease in Xinjiang by Sniffin′Olfactory Rod Method

目的选用Sniffin′嗅棒检测方法评价新疆维吾尔自治区阿尔茨海默病(Alzheimer′s disease,AD)病人的嗅觉功能及其影响因素,了解新疆维吾尔自治区AD伴发嗅觉障碍(OD)病人的临床特征。方法采用病例-对照研究方法,利用Sniffin′嗅棒测试对50例新疆维吾尔自治区AD病人(AD组)和50名健康者(对照组)检测嗅觉阈值(THR)、嗅觉辨别(DIS)和识别能力(ID),探讨AD与嗅觉障碍的相关性。结果①在50例AD病人中,AD-OD 33例(66.0%),AD-NOD 17例(34.0%)。对照组50名中,OD有2例(4.0%),NOD有48例(96%);AD组嗅觉障碍发生率明显高于对照组(P<0.05)。②AD组嗅觉功能TDI、THR、DIS及ID评分均明显低于对照组(P<0.05),整体CDR分层后TDI、THR、DIS及ID评分差异有统计学意义(P<0.05)。③与AD-NOD组相比,AD-OD组简易精神状态检查(MMSE)、蒙特利尔认知评估量表(MoCA)评分均明显降低,AD组的嗅觉TDI、THR、DIS及ID评分与MoCA评分、MMSE评分呈正相关(P<0.05),与CDR呈负相关(P<0.05)。结论采用Sniffin′嗅棒检测提示AD病人嗅觉障碍的发生率较高;AD病人嗅觉障碍主要表现为THR、DIS、ID下降,随着认知功能下降,嗅觉功能呈现下降趋势。

Objective The Sniffin′s olfactory rod method was used to evaluate the olfactory function and its influencing factors in patients with Alzheimer′s disease(AD),and to understand the clinical features of AD with olfactory disturbance(OD).Methods A case-control study was conducted to detect the relationship between odor threshold,olfactory discrimination and recognition in 50 patients with AD and 50 healthy controls in Xinjiang by Sniffin′s olfactory rod test.Results There were 33 patients(66.0%)with AD-OD and 17 patients(34.0%)without OD(AD-NOD).Two(4.0%)had OD,and 48(96%)had NOD in control group.The frequency of olfactory disturbance in the AD group was significantly higher than that in the control group(P<0.05).The TDI,olfactory threshold(THR),odour discrimination(DIS),and olfactory identification(ID)scores of the AD group were significantly lower than those of the control group(P<0.05).The differences of TDI,THR,DIS,and ID scores were statistically significant(P<0.05).Compared with the AD-NOD group,Mini-Mental State Examination(MMSE)and the Montreal Cognitive Assessment(MoCA)Scale scores in the AD-OD group were significantly lower.The olfactory TDI,THR,DIS,and ID scores of the AD group were positively correlated with MoCA score and MMSE score(P<0.05),and negatively correlated with CDR(P<0.05).Conclusion The use of Sniffin′olfactory rod test indicates that the incidence of dysosmia in AD patients is higher.AD olfactory disorder is mainly characterized by decreased olfactory threshold,olfactory discrimination ability and olfactory identification ability.The olfactory function is decreased with the decline of cognitive function.