多发性硬化和视神经脊髓炎谱系疾病的嗅觉功能研究

Olfactory function in multiple sclerosis and neuromyelitis optica spectrum disorders

目的通过嗅觉测试探讨多发性硬化(MS)和视神经脊髓炎谱系疾病(NMOSD)嗅觉功能差异。方法收集2021年1月至2022年2月贵州医科大学附属医院临床确诊的MS患者21例、NMOSD患者20例及健康对照21例,使用简体中文版宾夕法尼亚大学嗅觉识别测试(UPSIT)检测嗅觉情况,贝克抑郁量表(BDI)评价情绪,简易精神状态检查量表(MMSE)评价认知功能。结果与对照组及NMOSD组比较,MS组UPSIT测试得分均较低(分别P<0.0001、P<0.05)。“椰子”(χ^(2)=8.32,P<0.05)、“烟”(χ^(2)=8.98,P<0.05)、“柠檬”(χ^(2)=12.26,P<0.01)、“花生”(P<0.01)气味识别正确率三组间比较差异有统计学意义;组间两两比较显示,与对照组比较,MS组“椰子”(χ^(2)=8.40,P<0.025)、“烟”(χ^(2)=6.86,P<0.025)、“柠檬”(χ^(2)=11.67,P<0.025)气味识别正确率低,NMOSD组“烟”(χ^(2)=7.55,P<0.025)、柠檬(χ^(2)=6.94,P<0.025)气味识别正确率低;余两两比较差异均无统计学意义(P>0.05)。UPSIT测试得分鉴别MS和NMOSD的ROC分析,曲线下面积(area under curve,AUC)为0.7369(95%CI:0.5838~0.8900,P=0.0095),Cut-off值为28.5,敏感性为70.00%,特异性为71.43%。结论MS嗅觉功能较NMOSD更差。MS和NMOSD均有几种特殊气味的识别正确率低于健康对照组。

Objective Olfactory test was used to evaluate difference in olfactory function between multiple sclerosis(MS)and neuromyelitis optica spectrum disorders(NMOSD).Methods Twenty-one MS patients,20 NMOSD,and 21 healthy controls(HC)were recruited from January 2021 to February 2022 in Affiliated Hospital of Guizhou Medical University.The olfactory was tested by the simplified Chinese version of the University of Pennsylvania Smell Identification Test(UPSIT),the emotion was evaluated by the Beck Depression Inventory(BDI),and the cognitive function was evaluated by the Mini-Mental State Examination(MMSE).Results UPSIT scores of MS patients was lower than that of HC and NMOSD(P<0.0001,P<0.05,respectively).Among the recognition accuracy rate of UPSIT items,“coconut”(χ^(2)=8.32,P<0.05),“smoke”(χ^(2)=8.98,P<0.05),“lemon”(χ^(2)=12.26,P<0.01),“peanut”(P<0.01)showed significant differences among three groups;Compared with HC the recognition accuracy rate of“coconut”(χ^(2)=8.40,P<0.025),“smoke”(χ^(2)=6.86,P<0.025)and“lemon”(χ^(2)=11.67,P<0.025)were lower in the MS.Compared with HC,the recognition accuracy rate of“smoke”(χ^(2)=7.55,P<0.025)and“lemon”(χ^(2)=6.94,P<0.025)were lower in the NMOSD.There was no significant difference in other items between groups(P>0.05).Receiver operating characteristic curve(ROC)showed that the area under the curve was 0.7369(95%CI:0.5838~0.8900,P=0.0095)and the cut-off value was 28.5.The sensitivity was 70.00%,and the specificity was 71.43%.Conclusions The olfactory function of MS was worse than that in NMOSD.The recognition accuracy rate of several special odors in MS and NMOSD were lower than HC.