嗅觉障碍患者主、客观嗅觉功能及生活质量评估
摘要
目的：探讨帕金森病(Parkinson's disease, PD)患者的嗅觉功能改变,嗅球体积、嗅沟深度改变特点,以及嗅球体积和嗅觉功能相关性。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 potential, OERP)检查,比较其主观嗅觉识别阈和嗅觉事件相关电位P2波潜伏期的差异。采用T&T嗅觉测试计对30名PD患者和与其年龄、性别相匹配的健康人进行嗅觉识别阈测定,并对这60名受试者进行头部MRI,通过MRI测量嗅球体积和嗅沟深度。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患者组两个年龄段的主观嗅觉识别阈均明显高于对照组(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)ms、(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)ms、(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)ms、(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)ms、(526.8±62.0)ms,PD组两个年龄段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。所有受试者的MRI均能清晰显示嗅沟及嗅球。PD组嗅觉识别阂(3.82±1.25)明显高于对照组(0.45±0.65),差异有统计学意义(P=0.000,t=14.590)。PD组最佳嗅球体积(37.30±10.23mm3)明显小于对照组(44.87±11.84mm3),差异有统计学意义(P=0.006,t=-2.988)。PD组最佳嗅沟深度(8.90±1.42mm)明显小于对照组(9.67±1.24mm),差异有统计学意义(P=0.028,t=-2.316)。PD组嗅觉识别阈和最佳嗅球体积之间存在相关性(r=-0.448,P=0.000)。对照组嗅觉识别阈和最佳嗅球体积治疗也存在相关性(r=-0.420,P=0.021)。PD组及对照组嗅觉识别阈和最佳嗅沟深度之间均不存在相关性(r=-0.045,P=0.813,r=-0.097,P=0.610)。结论PD患者主观嗅觉识别阈明显比对照组差,OERP P2波潜伏期明显长于对照组；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。“最佳嗅球体积”和“最佳嗅沟深度”可以作为PD患者的嗅觉影像检查手段,有助于PD的诊断。“最佳嗅球体积”和嗅觉识别阈之间的显著相关性为今后进一步研究嗅觉结构和功能的关系提供了线索,也为PD的临床研究提供了一个有价值的指标。
目的：：分析以嗅觉障碍为唯一症状的慢性鼻一鼻窦炎患者的嗅觉功能及治疗效果。方法：28例仅有嗅觉障碍患者。影像学检查证实为慢性鼻一鼻窦炎；进行布地奈德混悬剂鼻腔脉冲气动喷射雾化吸入治疗。所有患者均进行治疗前后主观嗅觉识别阈,鼻窦CT检查后进行Land-Mackay评分,16例患者进行嗅觉事件相关电位检查。结果：①治疗前病程≤12个月和>12个月患者的主观嗅觉识别阈得分中位数及四分位间距、平均秩和分别为5.8、0.6、27.75和5.8、0.0、30.75。两组间差异并无统计学意义(Z=-0.765,P=0.444)。筛窦、上颌窦炎性病变发生率高于蝶窦和额窦(P<0.01)。两组患者Lund-Mackay评分中上颌窦、前组筛窦、后组筛窦、额窦、蝶窦、窦口鼻道复合体及总分得分差异均无统计学意义(Z=-0.276、-0.220、-0.759、-0.353、-0.000、-0.125,P=0.782、0.82.6、0.448、0.820、0.724、1.000、0.900)。主观嗅觉功能识别阈得分和Lund-Mackay上颌窦、前组筛窦、额窦、蝶窦和总分之间无显著相关性(r=-0.052、0.121、-0.097、-0.062、-0.192和-0.088,P=0.707、0.379、0.482、0.653、0.161和0.522)。②≤12个月,>12个月两组患者治疗后主观嗅觉识别阈中位数及四分位间距分别为2.8、2.4,1.7、1.95,与治疗前相比差异有显著统计学意义(Z=-3.065、-5.363,P=0.002、0.000)。不同病程患者治疗后嗅觉主观识别阂改善值中位数及四分位间距分别为3.8、2.6,3.0、3.05；两组间差异有统计学意义(Z=-1.992,P=0.046)。治疗后主观嗅觉功能识别阈得分和Lund-Mackay上颌窦、前组筛窦、额窦、蝶窦、鼻道窦口复合体和总分之间无显著相关性(r=0.102、-0.043、-0.038、0.081、0.194、0.026和0.088,P=0.456、0.755、0.782、0.552、0.152、0.848和0.519)。治疗前后嗅觉事件相关电位引出率之间差异有统计学意义(x2=40.040,P 目的：研究嗅觉障碍生存质量量表(Questionnaire of Olfactory Disorders,QOD)的信效度,并探讨嗅觉障碍生存质量量表(QOD)、医学结局研究问卷36项(medical outcome study short form-36, MOSSF-36,SF-36)、世界卫生组织生存质量测定量表简表(World Health Organization quality of life-brief, WHOQOL-BREF)量表在嗅觉障碍患者生存质量评价中的应用。方法：对以嗅觉障碍就诊的104名患者和30名健康对照者进行嗅觉障碍生存质量量表、SF-36、WHOQOL-BREF量表测定；并采用前瞻性自身对照研究,对患者中的30例进行糖皮质激素鼻腔脉冲气动喷射雾化吸入治疗,进行治疗前后生存质量测定。结果：共调查125名患者,回收125份(100%),完成QOD量表119份,完成QOD, SF-36, WHOQOL-BREF3个量表104份。QOD量表QOD-P, QOD-QOL, QOD-VAS的重测信度为0.802,0.797,0.468,量表分半信度为0.70,克朗巴赫系数a (Cronbach's alpha)0.473,0.814,0.882。QOD-P部分与SF-36各维度相关性分别为-0.094、-0.152、0.056、0.006、-0.176、-0.201、-0.113和-0.086；QOD-QOL相关性分别为-0.393、-0.376、-0.273、-0.243、-0.356、-0.500、-0.411和-0.299；QOD-VAS的相关性-0.373、-0.484、-0.288、-0.290、-0.463、-0.598、-0.577和-0.358。QOD-P部分与WHOQOL-BREF各维度相关性分别为0.051、-0.041、0.030、-0.022、0.041、0.037和-0.043;QOD-QOL的相关性为-0.338、-0.311、-0.158、-0.333、0.172、-0.397和-0.281;QOD-VAS的相关性为-0.378、-0.356、-0.184、-0.406、0.263、-0.393和-0.398。不同嗅觉功能组间QOD-P, QOD-VAS部分未显示出明显差异(F=0.145,1.751,P=0.865、0.179),QOD-QOL部分差异有统计学意义(F=3.607,P=0.031)。实验组与对照组QOD-P, QOD-QOL, QOD-VAS部分差异有统计学意义(t=2.852、5.975、8.526,P=0.005、0.000、0.000)。30例经过治疗的患者治疗前后QOD-P部分差异无统计学意义(t=-0.070,P=0.944),QOD-QOL, QOD-VAS部分之间差异有统计学意义(t=-4.047,4.139,P=0.000、0.000)。T&T识别阈与SF-36各维度、WHOQOL-BREF各维度并无显著相关性(r=-0.190、0.027、-0.126、0.041、0.099、0.109、0.018、0.120、-0.033、0.178、0.133、0.063,p=0.054、0.784、0.203、0.684、0.322、0.275、0.860、0.226、0.744、0.072、0.181、0.528);棒状嗅觉鉴别率与SF-36、WHOQOL-BREF各维度之间无显著相关性(r=-0.005、0.148、-0.017、-0.106、-0.059、0.004、-0.081、0.030、-0.158、-0.147、-0.058,p=0.961、0.134、0.861、0.288、0.557、0.970、0.417、0.763、0.112、0.138、0.560)。结论：嗅觉功能障碍对患者生存质量存在影响。普适性生存质量量表SF-36, WHOQOL-BREF虽然具有一定信效度,但是对于发现和评估嗅觉障碍对生存质量的影响程度不够敏感。简体中文版嗅觉障碍生存质量量表具有良好的信效度,其中QOD-QOL部分信效度最高,可以用于嗅觉障碍患者生存质量的评估；QOD-VAS部分信效度亦较高,适当调整后可以用于临床评估；QOD-P部分由于涉及到嗅觉性质障碍,在本研究中信效度均不高,需要重新设计调整。
[Abstract] Objective To study the olfactory function test in Parkinson's disease(PD), in order to promote the diagnosis of the PD. Olfactory dysfunction is commonly associated with IPD. We here report the association of OB volume and OS depth with olfactory function in patients with PD,Methods subjects included95middle-aged volunteers and37PD patients. 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. Morphometric analyses by using MR imaging and the Japanese T&T olfactometer threshold test were used to evaluate olfactory structure and function in29patients with PD and29age-and sex-matched healthy controls. Results:The T&T olfactometer results for the2sides were4.6±1.1,1.4±1.2in PD patients older than70years old and3.9±1.7,4.0±1.7in those. respectively; while the data were0.4±0.9,0.4±0.9in volunteers older than70years, were0.5±0.8,0.5±0.8younger than70years old. There was a significant difference in T&T olfactometer results between PD and voluteers(t=15.246,15.378,8.664,8.776; P<0.01). The P2latencies were respectively(734.9±143.2) ms,(696.1±165.9)ms for the2sides in PD older than70years, and (730.5±159.4) ms,(719.5±159.2)ms in PD younger than70years; while they were(547.9±65.0) ms,(558.5±56.3)ms, and(523.3±61.9) ms,(526.8±62.0)ms in volunteers younger than70years. There was a significant difference in P2latency between PD and Volunteers (t=-3.940,-3.750,-7.514,-8.205,P<0.01). The olfactory recognition thresholds were significantly higher in patients with PD than in healthy controls (3.82±1.25versus0.45±0.65, P<.001). Olfactory atrophy with reductions in the volume of the OB (37.30±10.23mm3versus44.87±11.84mm3, P<0.05) and in the depth of OS (8.90±1.42mm versus9.67±1.24mm, P<0.05) was observed in patients with PD but not in controls. Positive correlations between olfactory performance and OB volumes were observed in both patients with PD (r=-0.45, P<0.0001) and in controls (r=-0.42, P<0.0001). In contrast, there was no significant correlation between the depth of OS and olfactory function in either cohort. Conclusion:Olfactory dysfunction is an important index in PD. Olfactory function test is an useful method in the diagnosis of PD. The results provide evidence that early olfactory dysfunction in patients with PD may be a primary consequence of damage to the OB. Neuroimaging of olfactory structures together with the assessment of olfactory function may be used to identify patients with PD.
Abstract Objective:To analyses the clinical characteristics of28chronic rhino-sinusitis patients only characterized olfactory disorders. Method: Twenty-eight patients who have only olfactory disorder were diagnosed chronicrhino-sinusitis, all the patients accepted intranasal budesonide for15days. All patients accepted CT scan, T&T test, and16patients accepted olfactory event-related potentials test before and after treatment. Results:①No difference was found between21patients (≤12months)and7patients (>12months)(P>0.05), significant difference was found between maxillary sinus, ethmoid sinus and frontal sinus, sphenoid sinus in CT scan(P<0.01). There is not relationship between the T&T test and the Lund-Mackay (r=0.102、-0.043、-0.038、0.081、0.194、0.026and0.088, P=0.456、0.755、0.782、0.552、0.152、0.848and0.519).①Olfactory function improves after treatment(Z=-3.065、-5.363, P=0.002,0.000). There is significant difference between the two groups'T&T test improvement (Z=-1.992, P=0.046). There is relationship between T&T test and P2latency. Conclusion:①Chronic rhino-sinusitis patients who have only olfactory disorder were found;②Intranasal budesonide treatment could improve olfactory functions of chronic rhino-sinusitis'patients;③There is not relationship between the Lund-Mackay and the T&T test;④The objective olfactory function evaluation method relates the subjective method;⑤Short history patients' olfactory function recovery easily.
[Abstract] Objective To study the quality of life of patients suffered from olfactory dysfunction, and to investigate the SF-36, WHOQOL-BREF and QOD. Methods Concerning the items list by SF-36, WHOQOL-BREF and QOD and the results of T&T olfactory test and Odor Stick Identification Test. The samples includes104olfactory dysfunction patients and30normal person. Results:104patients of125completed the survey,30patients completed the survey before and after the treatment. The two-weeks test-retest reliability coefficients of QOD-P, QOD-QOL, QOD-VAS were0.802,0.797and0.468. The Cronbach'a coefficients of internal consistency reliability were0.473、0.814、0.882. There were not correlation between the QOD-P and SF-36(r=-0.094、-0.152、0.056、0.006、-0.176、-0.201、-0.113and-0.086); but there were significant correlation between the QOD-QOL QOD-VAS and SF-36(r=-0.393、-0.376、-0.273、-0.243、-0.356、-0.500、-0.411and-0.299;-0.373、-0.484、-0.288、-0.290、-0.463、-0.598、-0.577and-0.358)=There were not correlation between the QOD-P and WHOQOL-BREF(r=0.051、-0.041、0.030、-0.022、0.041、0.037and-0.043); there were significant correlation between the QOD-QOL、QOD-VAS and SF-36(r=-0.338、-0.311、-0.158、-0.333、0.172、-0.397、-0.281;-0.378、-0.356、 -0.184、-0.406、0.263、-0.393、-0.398)。There was significant difference in different olfactory function group in QOD-QOL (F=3.607, P=0.031), but not difference in QOD-P, QOD-VAS (F=0.145,1.751, P=0.865、0.179).There was significant difference between the two groups in QOD-P, QOD-QOL, QOD-VAS(t=2.852、5.975、8.526, P=0.005、0.000、0.000). The significant difference can be found in QOD-QOL;QOD-VAS of30patients who accepted treatment between before and after treatment (t=-4.047,4.139, P=0.000、0.000); but not found in QOD-P(r=-0.070, P=0.944). There was not correlation between the T&T and SF-36, WHOQOL-BREF (r=-0.190、0.027、-0.126、0.041、0.099、0.109、0.018、0.120、-0.033、0.178、0.133、0.063, P=0.054、0.784、0.203、0.684、0.322、0.275、0.860、0.226、0.744、0.072、0.181、0.528); and there was not correlation between Odor Stick Identification and SF-36、 WHOQOL-BREF (r=-0.005、0.148、-0.017、-0.106、-0.059、0.004、-0.081、0.030、-0.158、-0.147、-0.058, P=0.961、0.134、0.861、0.288、0.557、0.970、0.417、0.763、0.112、0.138、0.560).Conclusion:The olfactory dysfunction can influence the quality of olfactory dysfunction patient. The sf-36and WHOQOL-BREF were some suitable and effective, but not very sensitive for olfactory dysfunction patients. The Chinese-QOD was suitable and effective, the QOD-QOL was best, can apply in quality of life of olfactory dysfunction patients directly; but QOD-P, QOD-VAS need be adjusted for clinic practice.
目的：：分析以嗅觉障碍为唯一症状的慢性鼻一鼻窦炎患者的嗅觉功能及治疗效果。方法：28例仅有嗅觉障碍患者。影像学检查证实为慢性鼻一鼻窦炎；进行布地奈德混悬剂鼻腔脉冲气动喷射雾化吸入治疗。所有患者均进行治疗前后主观嗅觉识别阈,鼻窦CT检查后进行Land-Mackay评分,16例患者进行嗅觉事件相关电位检查。结果：①治疗前病程≤12个月和>12个月患者的主观嗅觉识别阈得分中位数及四分位间距、平均秩和分别为5.8、0.6、27.75和5.8、0.0、30.75。两组间差异并无统计学意义(Z=-0.765,P=0.444)。筛窦、上颌窦炎性病变发生率高于蝶窦和额窦(P<0.01)。两组患者Lund-Mackay评分中上颌窦、前组筛窦、后组筛窦、额窦、蝶窦、窦口鼻道复合体及总分得分差异均无统计学意义(Z=-0.276、-0.220、-0.759、-0.353、-0.000、-0.125,P=0.782、0.82.6、0.448、0.820、0.724、1.000、0.900)。主观嗅觉功能识别阈得分和Lund-Mackay上颌窦、前组筛窦、额窦、蝶窦和总分之间无显著相关性(r=-0.052、0.121、-0.097、-0.062、-0.192和-0.088,P=0.707、0.379、0.482、0.653、0.161和0.522)。②≤12个月,>12个月两组患者治疗后主观嗅觉识别阈中位数及四分位间距分别为2.8、2.4,1.7、1.95,与治疗前相比差异有显著统计学意义(Z=-3.065、-5.363,P=0.002、0.000)。不同病程患者治疗后嗅觉主观识别阂改善值中位数及四分位间距分别为3.8、2.6,3.0、3.05；两组间差异有统计学意义(Z=-1.992,P=0.046)。治疗后主观嗅觉功能识别阈得分和Lund-Mackay上颌窦、前组筛窦、额窦、蝶窦、鼻道窦口复合体和总分之间无显著相关性(r=0.102、-0.043、-0.038、0.081、0.194、0.026和0.088,P=0.456、0.755、0.782、0.552、0.152、0.848和0.519)。治疗前后嗅觉事件相关电位引出率之间差异有统计学意义(x2=40.040,P
[Abstract] Objective To study the olfactory function test in Parkinson's disease(PD), in order to promote the diagnosis of the PD. Olfactory dysfunction is commonly associated with IPD. We here report the association of OB volume and OS depth with olfactory function in patients with PD,Methods subjects included95middle-aged volunteers and37PD patients. 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. Morphometric analyses by using MR imaging and the Japanese T&T olfactometer threshold test were used to evaluate olfactory structure and function in29patients with PD and29age-and sex-matched healthy controls. Results:The T&T olfactometer results for the2sides were4.6±1.1,1.4±1.2in PD patients older than70years old and3.9±1.7,4.0±1.7in those. respectively; while the data were0.4±0.9,0.4±0.9in volunteers older than70years, were0.5±0.8,0.5±0.8younger than70years old. There was a significant difference in T&T olfactometer results between PD and voluteers(t=15.246,15.378,8.664,8.776; P<0.01). The P2latencies were respectively(734.9±143.2) ms,(696.1±165.9)ms for the2sides in PD older than70years, and (730.5±159.4) ms,(719.5±159.2)ms in PD younger than70years; while they were(547.9±65.0) ms,(558.5±56.3)ms, and(523.3±61.9) ms,(526.8±62.0)ms in volunteers younger than70years. There was a significant difference in P2latency between PD and Volunteers (t=-3.940,-3.750,-7.514,-8.205,P<0.01). The olfactory recognition thresholds were significantly higher in patients with PD than in healthy controls (3.82±1.25versus0.45±0.65, P<.001). Olfactory atrophy with reductions in the volume of the OB (37.30±10.23mm3versus44.87±11.84mm3, P<0.05) and in the depth of OS (8.90±1.42mm versus9.67±1.24mm, P<0.05) was observed in patients with PD but not in controls. Positive correlations between olfactory performance and OB volumes were observed in both patients with PD (r=-0.45, P<0.0001) and in controls (r=-0.42, P<0.0001). In contrast, there was no significant correlation between the depth of OS and olfactory function in either cohort. Conclusion:Olfactory dysfunction is an important index in PD. Olfactory function test is an useful method in the diagnosis of PD. The results provide evidence that early olfactory dysfunction in patients with PD may be a primary consequence of damage to the OB. Neuroimaging of olfactory structures together with the assessment of olfactory function may be used to identify patients with PD.
Abstract Objective:To analyses the clinical characteristics of28chronic rhino-sinusitis patients only characterized olfactory disorders. Method: Twenty-eight patients who have only olfactory disorder were diagnosed chronicrhino-sinusitis, all the patients accepted intranasal budesonide for15days. All patients accepted CT scan, T&T test, and16patients accepted olfactory event-related potentials test before and after treatment. Results:①No difference was found between21patients (≤12months)and7patients (>12months)(P>0.05), significant difference was found between maxillary sinus, ethmoid sinus and frontal sinus, sphenoid sinus in CT scan(P<0.01). There is not relationship between the T&T test and the Lund-Mackay (r=0.102、-0.043、-0.038、0.081、0.194、0.026and0.088, P=0.456、0.755、0.782、0.552、0.152、0.848and0.519).①Olfactory function improves after treatment(Z=-3.065、-5.363, P=0.002,0.000). There is significant difference between the two groups'T&T test improvement (Z=-1.992, P=0.046). There is relationship between T&T test and P2latency. Conclusion:①Chronic rhino-sinusitis patients who have only olfactory disorder were found;②Intranasal budesonide treatment could improve olfactory functions of chronic rhino-sinusitis'patients;③There is not relationship between the Lund-Mackay and the T&T test;④The objective olfactory function evaluation method relates the subjective method;⑤Short history patients' olfactory function recovery easily.
[Abstract] Objective To study the quality of life of patients suffered from olfactory dysfunction, and to investigate the SF-36, WHOQOL-BREF and QOD. Methods Concerning the items list by SF-36, WHOQOL-BREF and QOD and the results of T&T olfactory test and Odor Stick Identification Test. The samples includes104olfactory dysfunction patients and30normal person. Results:104patients of125completed the survey,30patients completed the survey before and after the treatment. The two-weeks test-retest reliability coefficients of QOD-P, QOD-QOL, QOD-VAS were0.802,0.797and0.468. The Cronbach'a coefficients of internal consistency reliability were0.473、0.814、0.882. There were not correlation between the QOD-P and SF-36(r=-0.094、-0.152、0.056、0.006、-0.176、-0.201、-0.113and-0.086); but there were significant correlation between the QOD-QOL QOD-VAS and SF-36(r=-0.393、-0.376、-0.273、-0.243、-0.356、-0.500、-0.411and-0.299;-0.373、-0.484、-0.288、-0.290、-0.463、-0.598、-0.577and-0.358)=There were not correlation between the QOD-P and WHOQOL-BREF(r=0.051、-0.041、0.030、-0.022、0.041、0.037and-0.043); there were significant correlation between the QOD-QOL、QOD-VAS and SF-36(r=-0.338、-0.311、-0.158、-0.333、0.172、-0.397、-0.281;-0.378、-0.356、 -0.184、-0.406、0.263、-0.393、-0.398)。There was significant difference in different olfactory function group in QOD-QOL (F=3.607, P=0.031), but not difference in QOD-P, QOD-VAS (F=0.145,1.751, P=0.865、0.179).There was significant difference between the two groups in QOD-P, QOD-QOL, QOD-VAS(t=2.852、5.975、8.526, P=0.005、0.000、0.000). The significant difference can be found in QOD-QOL;QOD-VAS of30patients who accepted treatment between before and after treatment (t=-4.047,4.139, P=0.000、0.000); but not found in QOD-P(r=-0.070, P=0.944). There was not correlation between the T&T and SF-36, WHOQOL-BREF (r=-0.190、0.027、-0.126、0.041、0.099、0.109、0.018、0.120、-0.033、0.178、0.133、0.063, P=0.054、0.784、0.203、0.684、0.322、0.275、0.860、0.226、0.744、0.072、0.181、0.528); and there was not correlation between Odor Stick Identification and SF-36、 WHOQOL-BREF (r=-0.005、0.148、-0.017、-0.106、-0.059、0.004、-0.081、0.030、-0.158、-0.147、-0.058, P=0.961、0.134、0.861、0.288、0.557、0.970、0.417、0.763、0.112、0.138、0.560).Conclusion:The olfactory dysfunction can influence the quality of olfactory dysfunction patient. The sf-36and WHOQOL-BREF were some suitable and effective, but not very sensitive for olfactory dysfunction patients. The Chinese-QOD was suitable and effective, the QOD-QOL was best, can apply in quality of life of olfactory dysfunction patients directly; but QOD-P, QOD-VAS need be adjusted for clinic practice.
引文
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13. Ship JA, Pearson JD, Cruise U, Brant U, Metter EJ. Longitudinal changes in smell identification.J Gerontol A Biol Sci Med Sci.1996 Mar;51(2):M86-91.
14. Costanzo RM, DiNardo LJ, Zasler ND, et al. Head injury and olfactory. ln:Doty RL, ed. Handbook of olfaction and Gustation. New York, NY:Marcel Dekker Inc; 1995:493-502.
15. Deems DA, Doty RL, Settle RG, et al.Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center.Arch Otolaryngol Head Neck Surg.1991 May;117(5):519-28.
16. Doty RL. A review of olfactory dysfunctions in man. Am J Otolaryngol.1979 Fall; 1(1):57-79.
17. Schiffman SS. Taste and smell in disease (first of two parts). N Engl J Med. 1983;308(21):1275-9.
18. Takaki Miwa, Mitsuru Furukawa, Toshiaki Tsukatani, et al. Impact of olfactory impairment on quality of life and disability. ARCH otolaryngol head neck surg. 2001;127:497-503.
19. Johannes Frasnelli, Thomas Hummel. Olfactory dysfunction and daily life Eur Arch Otorhinolaryngol.2005,262:231-235.
20. Bona Croy, Dorothee. Individual significance of olfaction:development of a questionnaire. Eur Arch Otorhinolaryngol.2010,267:67-71.
21. kimmelman CP. Clinic review of olfaction. Am J Otolaryngol,1993,14(4):227-239.
22. Bonfils P, Faulcon P, Tavernier L, Bonfils NA, Malinvaud D. Home accidents associated with anosmia. Presse Med 37:742-745
23. Santos DV, Reiter ER, DiNardo LJ, Costanzo RM. Hazardous events associated with impaired olfactory function.Arch Otolaryngol Head Neck Surg 130:317-329.
24. Temmel AF, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T. Characteristics of olfactory disorders in relation to major causes of olfactory loss.Arch Otolaryngol Head Neck Surg.2002 Jun;128(6):635-41.
25. Ware JE Jr, Snow KK, Kosinski M, et al. SF-36 health survey manual and interpretation guide. Boston:New England Medical Center the Health Institute, 1993.1-12.
26. Claudia Neuland, Thomas Bitter, Heike Marschner, et al. Health-Related and Specific Olfaction-Related Quality of Life in Patients with Chronic Functional Anosmia or Severe Hyposmia. Laryngoscope,2011,121:867-872.
27. Simopoulos E, Katotomichelakis M, Gouveris H, Tripsianis G, Livaditis M, Danielides V.Olfaction-associated quality of life in chronic rhinosinusitis: Adaptation and validation of an olfaction-specific questionnaire. Laryngoscope. 2012; 122(7):1450-4.
28. Welge-Lussen A. Ageing, neurodegeneration, and olfactory and gustatory loss. B-ENT 2009;5(suppl 13):129-132.
29. World Health Organization. WHOQOL User Manual. WHO, Geneva.1998.
30. Smeets MA, Veldhuizen MG, Galle S, Gouweloos J, de Haan AM, Vernooij J, Visscher F, Kroeze JH. Sense of smell disorder and health-related quality of life. Rehabil Psychol.2009 Nov;54(4):404-12.
31. Duncan HJ, Smith DV. Clinical disorders of olfaction. In:Doty RL Handbook of olfaction and gestation. Marcel Dekker, New York, pp 345-365.
32. Leopold D. Distortion of olfactory perception:diagnosis and treatment. Chem Senses 27:611-15.
1、陈彪,丁辉。应重视帕金森病的诊断与治疗。中国现代神经病杂志,2011,11：1-3。
2、Muller A, Reichmann H, Livermore A, et al. Olfactory function in idiopathic Parkinson's disease(IPD):results from cross-sectional studies in IPD patients and long-term follow-up of de-novo IPD patients. J Neural Transm,2002,109:805-811.
3、Tissingh G, Berendse HW, Bergmans P, et al. Loss of olfaction in de novo and treated Parkinson's disease:possible implications for early diagnosis. Mov Disord,2001,16:41-46.
4、Doty RL. Studies of human olfaction from the University of Pennsylvania Smell and Taste Center. Chem Sense,1997,22:565-586.
5、Doty RL, Deems DA, Stellar S. Olfactory dysfunction in Parkinsonism:a general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology,1988,38:1237-1244.
6、Ward CD, Hess WA, Calne DB. Olfactory impairment in Parkinson's disease. Neurology,1983,33:943-946.
7、Henderson JM, Lu Y, Wang S, et al. Olfactory deficits and sleep disturbances in Parkinson's disease:a case-control survey. J Neurol Neurosurg Psychiatry,2003,74:956-958.
8、王厹东,蔡定芳。帕金森病的嗅觉障碍。临床神经病学杂志,2002,15：38-39。
9、王剑、倪道凤、关静等.嗅觉功能检查在帕金森病诊断中的应用。中 华神经科杂志,2008,41(8)：524-527。
10、Hawkes CH, Shephard BC, Daniel SE. Olfactory dysfunction in Parkinson's disease. J Neuro Neurosurg Psychiatry,1997,62:436-446.
11、田立鹏,孙圣刚。定量嗅觉检测在帕金森病早期诊断中的应用。神经损伤与功能重建,2006,1：151-153。
12、Barz S, Hummel T, Pauli E, et al. Chemosensory event-related potentials in response to trigeminal and olfactory stimulation in idiopathic Parkinson's disease. Neurology,1997,49:1424-1431.
13、Meusel T, Westermann B, Fuhr P, et al. The course of olfactory deficits in patients with Parkinson's disease----a study based on psychophysical and electrophysiological measures. Neurosci Lett,2010,486:166-70.
14、J Wang, H You, JF Liu, et al. Association of olfactory bulb volume and olfactory sulcus with olfactory function in patients with Parkinson's disease. Am J Neuroradiol,2011,32:677-681.
15、Lerner A, Bagic A. Olfactory pathogenesis of idiopathic Parkinson disease revisited. Mov Disord 2008,23:1076-84.
16、Hummel T, Witt M, Reichmann H, et al. Immunohistochemical, volumetric,and functional neuroimaging studies in patients with idiopathic Parkinson's disease. J Neurol Sci 2010;289:119-22.
17、Mueller A, Abolmaali ND, Hakimi AR, et al. Olfactory bulb volumes in patients with idiopathic Parkinson's disease:a pilot study. J Neural Transm 2005;112:1363-70.
18、Huisman E, Uylings HB, Hoogland PV. A 100% increase of dopaminergic cells in the olfactory bulb may explain hyposmia in Parkinson's disease. Mov Disord 2004,19:687-92.
19、Rombaux P, Duprez T, Hummel T. Olfactory bulb volume in the clinical assessment of olfactory dysfunction. Rhinology 2009;47:3-9.
20、Scherfler C, Schocke MF, Seppi K. Voxel-wise analysis of diffusion weighted imaging reveals disruption of the olfactory tract in Parkinson's disease. Brain.2006,129(pt2):538-542.
21、吴晓阳。早期帕金森病患者嗅觉障碍扩赛张量成像。中国老年学杂志,2012,32：1161-1162。
22、Yoshikawa K. Nakata Y, Yamada K. Early pathological changes in the parkinsonian brain demonstrated by diffusion tensor MRI. JNeurol Neurosurg Psychiatry.2004,75(3):481-484.
1、Wysocki CJ, Gilbert AN (1989) National Geographic Smell Survey:effects of age are heterogenous. Ann N Y Acad Sci 561:12-28.
2、Hoffman HF, Ishii EK, Mac Turk RH. Age-related changes in the prevalence of smell/taste problems among the United States adult population: results of the 1994 disability supplement to the National Health Interview Survey(NHIS). Ann N Y Acad Sci.1998; 855:716-722.
3、Vennemann MM, Hummel T, Berger K. The association between smoking and smell and taste impairment in the generalpopulation. J Neurol 255(8):1121-1126.
4、Bramerson A et al. Prevalence of olfactory dysfunction:the Skovde population-based study. Laryngoscope 114(4):733-737.
5、Hummel T et al. Normative data for the "SniffinOn Sticks" including tests of odor identification, odor discrimination, andolfactory thresholds:an upgrade based on a group of more than3,000 subjects. Eur Arch Otorhinolaryngol 264:237-243.
6、Landis BN, Konnerth CG, Hummel T. A study on the frequency of olfactory dysfunction. Laryngoscope 114(10):1764-1769.
7、Murphy C et al. Prevalence of olfactory impairment in older adults. JAMA 288(18):2307-2312.
8、Ship JA, Pearson JD, Cruise LJ, Brant LJ, Metter EJ. Longitudinal changes in smell identification. J Gerontol A Biol Sci Med Sci.1996 Mar;51(2):M86-91.
9、Costanzo RM, DiNardo LJ, Zasler ND, et al. Head injury and olfactory. ln:Doty RL, ed. Handbook of olfaction and Gustation. New York, NY:Marcel Dekker Inc; 1995:493-502.
10、Deems DA, Doty RL, Settle RG, et al.Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center.Arch Otolaryngol Head Neck Surg.1991 May;117(5):519-28.
11、Doty RL. A review of olfactory dysfunctions in man. Am J Otolaryngol. 1979 Fall; 1(1):57-79.
12、Johannes Frasnelli, Thomas Hummel. Olfactory dysfunction and daily life Eur Arch Otorhinolaryngol.2005,262:231-235.
13、Bona Croy, Dorothee. Individual significance of olfaction:development of a questionnaire.
14、Eur Arch Otorhinolaryngol.2010,267:67-71.
15、kimmelman CP. Clinic review of olfaction. Am J Otolaryngol,1993,14(4): 227-239.
16、Bonfils P, Faulcon P, Tavernier L, Bonfils NA, Malinvaud D. Home accidents associated with anosmia. Presse Med 37:742-745
17、Santos DV, Reiter ER, DiNardo U, Costanzo RM. Hazardous events associated with impaired olfactory function.Arch Otolaryngol Head Neck Surg 130:317-329.
18、Temmel AF, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T. Characteristics of olfactory disorders in relation to major causes of olfactory loss.Arch Otolaryngol Head Neck Surg.2002 Jun;128(6):635-41.
19、Ware JE Jr, Snow KK, Kosinski M, et al. SF-36 health survey manual and interpretation guide. Boston:New England Medical Center the Health Institute,1993.1-12.
20、Claudia Neuland, Thomas Bitter, Heike Marschner, et al. Health-Related and Specific Olfaction-Related Quality of Life in Patients with Chronic Functional Anosmia or Severe Hyposmia. Laryngoscope,2011,121:867-872.
21、Simopoulos E, Katotomichelakis M, Gouveris H, Tripsianis G, Livaditis M, Danielides V.Olfaction-associated quality of life in chronic rhinosinusitis: Adaptation and validation of an olfaction-specific questionnaire. Laryngoscope.2012; 122(7):1450-4.
22、Welge-Lussen A. Ageing, neurodegeneration, and olfactory and gustatory loss. B-ENT 2009;5(suppl 13):129-132.
23、World Health Organization. WHOQOL User Manual. WHO, Geneva.1998.
24、Smeets MA, Veldhuizen MG, Galle S, Gouweloos J, de Haan AM, Vernooij J, Visscher F, Kroeze JH. Sense of smell disorder and health-related quality of life. Rehabil Psychol.2009 Nov;54(4):404-12.
25、Duncan HJ, Smith DV. Clinical disorders of olfaction. In:Doty RL Handbook of olfaction and gestation. Marcel Dekker, New York, pp 345-365.
26、Leopold D. Distortion of olfactory perception:diagnosis and treatment. Chem Senses 27:611-15.
2. Muler A, Reichmann H, Livemore A. et al. Olfactory function in idiopathic Parkinson's disease(IPD):results from cross-sectinonal studies in patients and long-term follow-up of de-novo IPD patients. J Neural Transm.2002,109:805-811.
3. Tissingh G, Berendse HW, Bergmans P, et al. Loss of olfaction in de novo and treated Parkinson's disease:possible implications foe early diagnosis. Mov Disord,2001,16:41-46.
4. Doty RL. Studies of human olfaction from the University of Pennsylvania Smell and Taste Center. Chem Senses,1997,22:565-586.
5. Doty RL, Deems DA, Stellar S. Olfactory dysfunction in parkinsonism: a general deficit unrelated to neurologic signs, disease stage, or disease duration. Neurology,1988,38:1237-1244.
6.田立鹏,孙圣刚.定量嗅觉检测在帕金森病早期诊断中的应用.神经损伤与 功能重建,2006,1：151-153。
7. Hawkes CH, Shephard BC, Daniel SE. Olfactory dysfunction in Parkinson's disease. J Neurol Neurosurg Psychiatry, 1997,62:436-446.
8.王厹东,蔡定芳.帕金森病的嗅觉障碍.临床神经病学杂志,2002.15：38-39.
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22. Mueller A, Abolmaali ND, Hakimi AR, Gloeckler T, Herting B, Reichmann H, Hummel T. Olfactory bulb volumes in patients with idiopathic Parkinson's disease a pilot study. J Neural Transm.2005 Oct;112 (10):1363-70. Epub 2005 Feb 15.
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8. Vennemann MM, Hummel T, Berger K. The association between smoking and smell and taste impairment in the generalpopulation. J Neurol 255(8):1121-1126.
9. Bramerson A et al. Prevalence of olfactory dysfunction:the Skovde population-based study. Laryngoscope 114(4):733-737.
10. Hummel T et al. Normative data for the "SniffinOn Sticks" including tests of odor identification, odor discrimination, andolfactory thresholds:an upgrade based on a group of more than3,000 subjects. Eur Arch Otorhinolaryngol 264:237-243.
11. Landis BN, Konnerth CG, Hummel T. A study on the frequency of olfactory dysfunction. Laryngoscope 114(10):1764-1769.
12. Murphy C et al. Prevalence of olfactory impairment in older adults. JAMA 288(18):2307-2312.
13. Ship JA, Pearson JD, Cruise U, Brant U, Metter EJ. Longitudinal changes in smell identification.J Gerontol A Biol Sci Med Sci.1996 Mar;51(2):M86-91.
14. Costanzo RM, DiNardo LJ, Zasler ND, et al. Head injury and olfactory. ln:Doty RL, ed. Handbook of olfaction and Gustation. New York, NY:Marcel Dekker Inc; 1995:493-502.
15. Deems DA, Doty RL, Settle RG, et al.Smell and taste disorders, a study of 750 patients from the University of Pennsylvania Smell and Taste Center.Arch Otolaryngol Head Neck Surg.1991 May;117(5):519-28.
16. Doty RL. A review of olfactory dysfunctions in man. Am J Otolaryngol.1979 Fall; 1(1):57-79.
17. Schiffman SS. Taste and smell in disease (first of two parts). N Engl J Med. 1983;308(21):1275-9.
18. Takaki Miwa, Mitsuru Furukawa, Toshiaki Tsukatani, et al. Impact of olfactory impairment on quality of life and disability. ARCH otolaryngol head neck surg. 2001;127:497-503.
19. Johannes Frasnelli, Thomas Hummel. Olfactory dysfunction and daily life Eur Arch Otorhinolaryngol.2005,262:231-235.
20. Bona Croy, Dorothee. Individual significance of olfaction:development of a questionnaire. Eur Arch Otorhinolaryngol.2010,267:67-71.
21. kimmelman CP. Clinic review of olfaction. Am J Otolaryngol,1993,14(4):227-239.
22. Bonfils P, Faulcon P, Tavernier L, Bonfils NA, Malinvaud D. Home accidents associated with anosmia. Presse Med 37:742-745
23. Santos DV, Reiter ER, DiNardo LJ, Costanzo RM. Hazardous events associated with impaired olfactory function.Arch Otolaryngol Head Neck Surg 130:317-329.
24. Temmel AF, Quint C, Schickinger-Fischer B, Klimek L, Stoller E, Hummel T. Characteristics of olfactory disorders in relation to major causes of olfactory loss.Arch Otolaryngol Head Neck Surg.2002 Jun;128(6):635-41.
25. Ware JE Jr, Snow KK, Kosinski M, et al. SF-36 health survey manual and interpretation guide. Boston:New England Medical Center the Health Institute, 1993.1-12.
26. Claudia Neuland, Thomas Bitter, Heike Marschner, et al. Health-Related and Specific Olfaction-Related Quality of Life in Patients with Chronic Functional Anosmia or Severe Hyposmia. Laryngoscope,2011,121:867-872.
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