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[病毒感染后嗅觉功能障碍患者治疗后嗅觉改善的预测因素]

[Predictors of posttreatment olfactory improvement in patients with postviral olfactory dysfunction].

作者信息

Guo Yichen, Yao Linyin, Sun Zhifu, Huang Xiaobing, Liu Jia, Wei Yongxiang

机构信息

Department of Otolaryngology Head and Neck Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,China.

Department of Otorhinolaryngology Head and Neck Surgery,Capital Institute of Pediatrics.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec;35(12):1057-1062. doi: 10.13201/j.issn.2096-7993.2021.12.001.

Abstract

To analyzed the results of olfactory function test in patients with post-viral olfactory dysfunction(PVOD), and evaluated the prognostic factors, so as to provide a basis for clinical diagnosis and treatment. This study included patients who were diagnosed with PVOD at least one year ago in Beijing Anzhen Hospital and whose telephone interviews of subjective olfactory function were available. The general condition of the patients, the results Sniffin' Sticks olfactory test and the event-related potentials(ERPs) were analyzed in different improvement groups. This study retrospectively analyzed PVOD patients treated in the outpatient department of Beijing Anzhen Hospital. They were given olfactory training for 4 months. The Sniffin' Sticks test was performed on the patients before and after the treatment. The Sniffin' Sticks test and event-related potentials(ERPs) results were used to evaluate the prognostic factors. In this study, the olfactory improvement rate of 63 PVOD patients was 52.38%(33/63). Compared to the non-improvement group, the course of disease in the group with improved subjective olfactory function was significantly shorter(<0.001), the initial olfactory function was significantly better(<0.001), and the olfactory threshold was much lower(<0.001). The presence of olfactory event-related potentials and trigeminal ERPs(tERPs) were 52.38%(33/63) and 87.30%(55/63), respectively. The presence of oERPs in the olfactory function improvement group was significantly higher than that in the non-improvement group(<0.05), but there was no difference in the presence of tERPs(>0.05). Latency of N1 and P2 waves in oERPs with improvement group(ON1L, OP2L) were longer than those in the non-improvement group(<0.05), N1 and P2 wave amplitudes(ON1A, OP2A) had no difference(>0.05). The N1 and P2 amplitudes and latency of tERPs showed no difference between the two groups. Multivariate Logistic regression analysis showed that threshold value before treatment(=21.376, 95%: 2.172-210.377, =0.009); ON1L(=0.994, 95%: 0.988-0.999, =0.029) and course of disease(=0.607, 95% 0.405-0.920, =0.016) was significantly associated with olfactory prognosis. The course of olfactory dysfunction, the severity of olfactory dysfunction, the threshold of olfactory function, and the latency of N1 wave of oERPs can be used to evaluate the prognosis of PVOD patients. However, age, olfactory discrimination, recognition ability, oERPs amplitude and tERPs wave value had less prognostic value.

摘要

分析病毒性嗅觉功能障碍(PVOD)患者嗅觉功能测试结果,评估预后因素,为临床诊断和治疗提供依据。本研究纳入至少1年前在北京安贞医院被诊断为PVOD且有主观嗅觉功能电话访谈资料的患者。在不同改善组中分析患者的一般情况、嗅棒嗅觉测试结果及事件相关电位(ERPs)。本研究回顾性分析在北京安贞医院门诊治疗的PVOD患者。他们接受了4个月的嗅觉训练。治疗前后对患者进行嗅棒测试。用嗅棒测试和事件相关电位(ERPs)结果评估预后因素。本研究中,63例PVOD患者的嗅觉改善率为52.38%(33/63)。与未改善组相比,主观嗅觉功能改善组的病程明显较短(<0.001),初始嗅觉功能明显较好(<0.001),嗅觉阈值低得多(<0.001)。嗅觉事件相关电位和三叉神经ERPs(tERPs)的出现率分别为52.38%(33/63)和87.30%(55/63)。嗅觉功能改善组中oERPs的出现率明显高于未改善组(<0.05),但tERPs的出现率无差异(>0.05)。改善组oERPs中N1和P2波的潜伏期(ON1L、OP2L)长于未改善组(<0.05),N1和P2波振幅(ON1A、OP2A)无差异(>0.05)。两组tERPs的N1和P2振幅及潜伏期无差异。多因素Logistic回归分析显示,治疗前阈值(=21.376,95%:2.172 - 210.377,=0.009);ON1L(=0.994,95%:0.988 - 0.999,=0.029)和病程(=0.607,95% 0.405 - 0.920,=0.016)与嗅觉预后显著相关。嗅觉功能障碍的病程、嗅觉功能障碍的严重程度、嗅觉功能阈值及oERPs的N1波潜伏期可用于评估PVOD患者的预后。然而,年龄、嗅觉辨别力、识别能力、oERPs振幅和tERPs波值的预后价值较小。

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