变应性和非变应性鼻炎患者嗅觉状态评估

Mann S S, Maini Sangeeta, Nageswari K Sri, Mohan Harsh, Handa Aru

Department of E.N.T., Govt. Medical College, Sector 38, Prayaas Building, Chandigarh-160 012.

Indian J Physiol Pharmacol. 2002 Apr;46(2):186-94.

A study undertaken to assess the olfactory acuity in allergic (group I) and non-allergic rhinitis (group II) patients in comparison with age and sex matched controls (group III). Patients presenting with atleast three of the five cardinal symptoms of rhinitis i.e. rhinorrhoea, sneezing, itching, headache and nasal obstruction were grouped as non-infective rhinitis and further divided into allergic rhinitis (group I, n = 20) and non-allergic rhinitis (group II, n = 20) based on nasal smear cytology positivity or negativity for eosinophils respectively. Detailed Ear, Nose and Throat examination was carried out in both the groups and peripheral blood samples were analysed for total, differential leukocyte and absolute eosinophil counts using standard techniques. In all the three groups the olfactory thresholds for 5 odorants i.e. musk (M), formalin (F), camphor (C), asafoetida (A, 10% aqueous solution) and oil of peppermint (P, 20%) were evaluated for testing musky, pungent, camphorous, putrid and minty odours respectively by the method described by Elsberg and Levy for quantitative olfactometry. The results indicated elevation of olfactory thresholds (delta %, calculated taking control values as 100%) for 4 or 5 odorants in group I and group II patients respectively as compared with controls (group I: delta % for P--89.6%; M--116.4%; A--55.8%; P < 0.001; C--73.1%; P < 0.02; F--26.6% N.S.; group II: P--96.9%; M--99.3%, P < 0.01 for both; A--66.8%; C--102.7%, P < 0.001; F--42%, P < 0.05). In the non allergic rhinitis group the magnitude of the olfactory loss was more severe except for the odorant musk. Further interpretations as per gender based specificities revealed more severe olfactory loss in males of both the groups for the odorants peppermint and musk and moderately severe olfactory loss for formalin and camphor as compared to females. However, for the odorant asafoetida females showed greater olfactory loss than males in both the groups (delta % 73.38% versus 52% in group I and 81.29% versus 69.7% in group II).

一项研究旨在评估过敏性鼻炎患者（第一组）和非过敏性鼻炎患者（第二组）的嗅觉敏锐度，并与年龄和性别匹配的对照组（第三组）进行比较。出现鼻炎至少五种主要症状中的三种，即鼻溢液、打喷嚏、瘙痒、头痛和鼻塞的患者被归类为非感染性鼻炎，并根据鼻涂片细胞学检查嗜酸性粒细胞阳性或阴性，进一步分为过敏性鼻炎（第一组，n = 20）和非过敏性鼻炎（第二组，n = 20）。对两组患者均进行了详细的耳鼻喉检查，并使用标准技术分析外周血样本中的白细胞总数、分类计数和绝对嗜酸性粒细胞计数。在所有三组中，使用Elsberg和Levy描述的定量嗅觉测定法，评估了5种气味剂的嗅觉阈值，即麝香（M）、福尔马林（F）、樟脑（C）、阿魏（A，10%水溶液）和薄荷油（P，20%），分别用于测试麝香、刺鼻、樟脑、腐臭和薄荷气味。结果表明，与对照组相比，第一组和第二组患者中分别有4种或5种气味剂的嗅觉阈值升高（以对照组值为100%计算δ%）（第一组：P的δ%为89.6%；M为116.4%；A为55.8%；P<0.001；C为73.1%；P<0.02；F为26.6%，无统计学意义；第二组：P为96.9%；M为99.3%，两者P<0.01；A为66.8%；C为102.7%，P<0.001；F为42%，P<0.05）。在非过敏性鼻炎组中，除了麝香气味剂外，嗅觉丧失的程度更严重。根据基于性别的特异性进行的进一步分析显示，与女性相比在两组男性中，薄荷和麝香气味剂的嗅觉丧失更严重，福尔马林和樟脑的嗅觉丧失为中度严重。然而，对于阿魏气味剂，两组中女性的嗅觉丧失均比男性更大（第一组δ%为73.38%对52%，第二组δ%为81.29%对69.7%）。