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摘要: 目的: 分析阿尔茨海默病(AD)患者主观嗅觉功能以及嗅球体积、嗅沟深度与嗅觉功能的相关性。方法: 选取AD患者(AD组)及健康受试者(对照组)各50例,应用T&T嗅觉测试法检查所有受试者的嗅觉功能,并行头颅MRI扫描分析其嗅球体积、嗅沟深度。结果: AD组T&T嗅觉识别阈分数(2.80±0.31)显著高于对照组(1.50±0.17),差异有统计学意义(P<0.05)。左右两侧嗅球体积及平均嗅球体积AD组分别为(29.78±5.17)、(30.14±4.87)、(30.05±5.08)mm3,对照组分别为(36.65±4.08)、(36.56±4.12)、(36.46±4.11)mm3;2组比较均差异有统计学意义(均P<0.01)。AD组与对照组左右两侧嗅沟深度均及平均嗅沟深度差异无统计学意义(均P>0.05)。AD组嗅觉识别阈与平均嗅球体积呈负相关(r=-0.711,P<0.05),嗅觉识别阈与平均嗅沟深度无相关性(r=-0.127,P>0.05)。结论: AD患者嗅球体积减小,嗅沟深度不变;嗅觉功能与嗅球体积具有相关性,与嗅沟深度无关;认知障碍的严重程度与嗅觉减退的程度具有一致性;嗅觉功能减退可作为AD患者早期客观的诊断指标。Abstract: Objective: To analyze the relationship between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with Alzheimer' disease (AD).Method: Fifty patients with AD patients and 50 healthy subjects were examined by olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI).Result: T&T olfactory testing revealed that AD patients had higher scores than control group (1.50±0.17,2.80±0.31,P<0.05).Bilateral and average OB volumes were smaller in AD group[(29.78±5.17)mm3, (30.14±4.87)mm3, (30.05±5.08)mm3] than in control group[(36.65±4.08)mm3, (36.56±4.12)mm3, (36.46±4.11)mm3] (P<0.01). OS depth study revealed no statistical difference between AD patients and control groups (P>0.05). Olfactory discriminate threshold was negatively correlated with average olfactory bulb volumes (r=-0.711,P<0.05), and was not correlated with depth of OS(r=-0.127,P>0.05) in AD patients.Conclusion: The OB volume were lower in AD patients as compare to controls, the depth of OS has no significant changes in AD patients; The OB volume is correlated with olfactory function, the depth of OS is no correlated with olfactory function. Cognitive impairment degree in AD patients is accordance with the lower degree olfactory function. The olfactory loss may be the earlier period and objective diagnosis indicator for AD patients.
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