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目的探讨帕金森病(Parkinson disease,PD)患者嗅觉功能障碍的发生率及相关特征,研究脑内嗅觉系统微观结构的改变。方法应用T&T嗅觉检测仪分别对PD患者组(n=160)和正常对照组(n=160)进行嗅觉功能测试,分析嗅觉识别阈值与年龄、病程及Hoehn-Yahr(H-Y)分级之间的关系,并对其中PD患者组(n=60)和正常对照组(n=60)进行弥散张量成像(diffusion tensor imaging,DTI)扫描,用基于体素形态测量学(voxe-based morphometry,VBM)评定各项异性分数(fractional anisotropy,FA)。结果 75.63%的PD患者(121/160例)存在嗅觉障碍,明显高于对照组。嗅觉障碍与年龄、病程和H-Y分级之间无明显相关性;VBM双样本分析显示,PD组双侧小脑白质及额叶,左侧直回、眶回及顶叶等区域,FA值显著小于对照组。结论大多数PD患者合并有嗅觉障碍,与病程、年龄及H-Y分级无关,脑内嗅觉系统存在微结构损伤,嗅觉功能检测结合DTI有助于PD的诊断。
Objective To investigate the incidence and related characteristics of olfactory dysfunction in patients with Parkinson disease (PD) and to study the changes of olfactory system microstructure in the brain. Methods The olfactory function of PD patients (n = 160) and normal control group (n = 160) was tested by T & T olfactometer. The relationship between olfactory recognition threshold and age, course of disease and Hoehn-Yahr , And diffusion tensor imaging (DTI) scan was performed on PD patients (n = 60) and normal controls (n = 60). Voxel-based morphometry (VBM) The fractional anisotropy (FA) was assessed. Results 75.63% of PD patients (121/160 cases) had olfactory dysfunction, which was significantly higher than that of control group. There was no significant correlation between olfactory dysfunction and age, disease duration and HY classification. The results of VBM double-sample analysis showed that the FA values of bilateral cerebellar white matter and frontal lobe, left straight back, orbital gyrus and parietal lobe in PD group were significantly lower than those in control group. Conclusion Most patients with PD have olfactory dysfunction, which has nothing to do with the course of disease, age and grade of H-Y. Microscopic structure of the olfactory system in the brain is impaired. The combination of olfactory function test and DTI is helpful for the diagnosis of PD.