嗅觉功能检查在帕金森病诊断中的应用

目的 探讨帕金森病(Parkinson's disease,PD)患者的嗅觉功能改变特点.方法 对37例临床确诊的50岁以上PD患者和95名年龄匹配的健康中老年人进行T&T主观嗅觉识别阈测试和嗅觉事件相关电位(olfactory event related potentials,OERP)检查,比较其主观嗅觉识别阈和嗅觉事件相关电位P2潜伏期的差异.结果 ≥70岁的PD患者左、右侧鼻腔主观嗅觉识别阈分别为4.6±1.1、4.4±1.2,<70岁PD患者左、右侧鼻腔主观嗅觉识别阈分别为3.9±1.7、4.0±1.7;≥70岁的对照组左、右侧鼻腔主观嗅觉识别阈分别为0.4±0.9、0.4±0.9,<70岁对照组左、右侧鼻腔主观嗅觉识别阈分别为0.5±0.8、0.5±0.8;PD患者组的主观嗅觉识别阈明显高于对照组(t=15.246、15.378、8.664、8.776,P<0.01);≥70岁的PD患者左、右侧鼻腔OERP P2潜伏期分别为(734.9±143.2)、(696.1±165.9)ms,<70岁的PD患者左、右侧鼻腔OERP P2潜伏期分别为(730.5±159.4)、(719.5±159.2)ms;≥70岁的对照组左、右侧鼻腔OERP P2潜伏期分别为(547.9±65.0)、(558.5±56.3)ms,<70岁的对照组左、右侧鼻腔OERP P2潜伏期分别为(523.3±61.9)、(526.8±62.0)ms,OERP P2潜伏期则明显长于对照组(t=-3.940、-3.750、-7.514、-8.205,P<0.01);同时PD患者组的主观嗅觉识别阈和OERP的异常率明显高于对照组.结论 PD患者主观嗅觉识别阈测试和OERP P2潜伏期结果 明显比对照组差,提示嗅觉功能减退是PD的重要临床表现;嗅觉功能检查可以作为PD筛查、诊断的参考指标.

Olfactory function test in Parkinson's disease

Objective To study the offactory function test in Parkinson' s disease(PD), in order to promote the diagnosis of the PD. Methods Subjects included 95 middle-aged volunteers and 37 Pdpatients. A subjective olfactometry with T&T olfactometer was performed in all volunteers and patients.Olfactory event related potentials with isoamyl acetate were obtained in all volunteers and patients. Results The T&T olfactometer Results for the 2 sides were 4.6±1.1,4.4±1.2 in PD patients older than 70 years old and 3.9±1.7, 4.0±1.7 in those, respectively; while the data were 0.4±0.9,0.4±0.9 in volunteers older than 70 years, were 0.5±0.8,0.5±0.8 younger than 70 years old. There was a significant differencein T&T olfactometer Results between PD and volunteers (t=15.246,15.378,8.664,8.776, P<0.01). TheP2 latencies were respectively (734.9±143.2), (696.1±165.9) ms for the 2 sides in PD older than 70years, and (730.5±159.4), (719.5±159.2) ms in PD younger than 70 years;while they were (547.9±65.0), (558.5±56.3) ms, and (523.3±61.9), (526.8±62.0) ms in volunteers younger than 70 years.There was a significant difference in P2 latency between PD and volunteers (t = -3.940, -3.750,- 7. 514, - 8.205,P<0.01). Conclusions Olfactory dysfunction is an important index in PD. Olfactory function test is an useful method in the diagnosis of PD.