上呼吸道感染后嗅觉障碍患者脑形态学与嗅觉功能相关性分析

Correlation between brain morphology and olfactory functionin patients with post-infectious olfactory dysfunction

目的 通过探究上呼吸道感染后嗅觉障碍脑灰质形态变化,得出上呼吸道感染后嗅觉障碍患者嗅觉中枢结构的影像学特点。方法 选取上呼吸道感染后嗅觉障碍的患者24例与嗅觉功能正常的健康对照受试者20例,通过基于体素的大脑皮质形态学体积测量(VBM)比较患者的大脑灰质和白质体积与对照组的差异。结果 上呼吸道感染后嗅觉障碍组患者TDI[气味察觉阈(T)、气味辨别能力(D)、气味识别能力(I)]总分(16.45±5.62)分,T为(2.33±0.93)分,D为(6.54±2.60)分,I为(7.58±3.22)分;嗅觉障碍平均时长为(19.00±6.33)个月;视觉模拟量表评分(VAS)为(7.79±2.41)分,与对照组比较均存在统计学差异(P<0.05)。上呼吸道感染后嗅觉障碍患者的大脑灰质总体积和嗅皮质体积明显小于对照组(P<0.05),大脑灰质总体积占全脑体积的比例和皮质厚度与嗅觉功能评分TDI值呈正相关(r=0.71,P<0.000 1;r=0.69,P=0.000 9)。结论 上呼吸道感染后嗅觉障碍患者大脑灰质总体积和嗅皮质体积减少,且嗅觉功能与大脑灰质体积比例及皮质厚度呈正相关。

Objective To explore the morphological changes of gray matter in patients with olfactory dysfunction following upper respiratory tract infections,and obtain the imaging characteristics of olfactory center structure in patients with post-infectious olfactory dysfunction.Methods Twenty-four patients with post-infectious olfactory dysfunction(OD group)and 20 healthy subjects(control group)with normal olfactory function were selected.Voxel-based cortical morphometry was used to compare the volume of gray matter and white matter between the two groups.Results Of the OD group,the total ordor threshold,discrimination and identification(TDI)score was 16.45±5.62,while the threshold(T)score was 2.33±0.93,the discrimination(D)score was 6.54±2.60,and the identification(I)score was 7.58±3.22,the average duration of olfactory dysfunction was(19.00±6.33)months,and the visual analogue scale(VAS)score was 7.79±2.41.The differences of above-mentioned indexes between the OD group and the control group were all statistically significant(P<0.05).The total gray matter volume and olfactory cortex volume of the OD group were significantly smaller than those of the control group(P<0.05).The proportion of total gray matter volume to total brain volume and cortical thickness were positively correlated with olfactory function TDI score(r=0.71,P<0.0001;r=0.69,P=0.0009).Conclusion Patients with post-infectious olfactory dysfunction have decreased gray matter volume and olfactory cortex volume,and olfactory function is positively correlated with gray matter volume ratio and cortical thickness.