原发性干燥综合征中气味识别与嗅觉阈值的分离现象
Dissociation between odor identification and threshold in primary Sjögren's syndrome.
文献信息
| PMID | 42830356 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Eda Simsek |
| 作者单位 | Department of Otolaryngology, Kayseri City Hospital, Health Sciences University, Kayseri, Turkey. hekimeda@hotmail.com. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 本研究旨在比较原发性干燥综合征（pSS）患者与健康对照者的嗅觉阈值和气味识别表现，并评估嗅觉测试在该人群中的鉴别能力。
方法： 在这项前瞻性、单中心病例对照研究中，共纳入46例pSS患者和46例年龄、性别分布匹配的健康对照者。使用12项快速Sniffin' Sticks测试评估气味识别，并使用改良CCCRC正丁醇方案评估嗅觉阈值。分析嗅觉指标与疾病相关变量之间的关联。构建多变量线性回归和逻辑回归模型，并进行受试者工作特征（ROC）分析以评估鉴别性能。
结果： 与对照组相比，pSS患者的气味识别评分显著降低（p < 0.001），而两组之间的嗅觉阈值评分无差异。在pSS组内，未观察到嗅觉指标与ESSPRI、疾病持续时间、ESR或CRP之间存在显著关联；然而，由于排除了有器官受累的患者，这些发现不应被解释为反对活动依赖性嗅觉功能障碍的证据。在多变量分析中，pSS状态仍与较低的识别评分独立相关（p < 0.001）。ROC分析显示气味识别具有良好的鉴别性能（AUC = 0.828），最佳截断值为≤ 8（敏感性0.674；特异性0.891）。将阈值加入模型后仅带来极小改善（AUC = 0.837）。
结论： pSS患者表现出气味识别受损，而嗅觉阈值评分未观察到统计学显著差异。气味识别测试可作为辅助临床工具；然而，其诊断作用需要外部验证。研究设计不允许就嗅觉功能障碍与疾病活动性之间的关系得出确切结论。
证据等级： III。
英文摘要
PURPOSE: This study aimed to compare olfactory threshold and odor identification performance between patients with pSS and healthy controls, and to evaluate the discriminatory capacity of olfactory testing in this population.
METHODS: In this prospective, single-center case-control study, 46 patients with pSS and 46 age- and sex-distribution-matched healthy controls were enrolled. Odor identification was assessed using the 12-item Rapid Sniffin' Sticks test, and olfactory threshold was evaluated using a modified CCCRC n-butanol protocol. Associations between olfactory measures and disease-related variables were analyzed. Multivariable linear and logistic regression models were constructed, and receiver operating characteristic (ROC) analysis was performed to assess discriminatory performance.
RESULTS: Odor identification scores were significantly lower in patients with pSS compared with controls (p < 0.001), whereas olfactory threshold scores did not differ between groups. Within the pSS group, no significant associations were observed between olfactory measures and ESSPRI, disease duration, ESR, or CRP; however, because patients with organ involvement were excluded, these findings should not be interpreted as evidence against activity-dependent olfactory dysfunction. In multivariable analysis, pSS status remained independently associated with lower identification scores (p < 0.001). ROC analysis demonstrated good discriminatory performance for odor identification (AUC = 0.828), with an optimal cutoff of ≤ 8 (sensitivity 0.674; specificity 0.891). Adding threshold to the model resulted in minimal improvement (AUC = 0.837).
CONCLUSION: Patients with pSS exhibited impaired odor identification, whereas no statistically significant difference was observed in olfactory threshold scores. Odor identification testing may serve as an adjunctive clinical tool; however, its diagnostic role requires external validation. The study design does not permit firm conclusions regarding the relationship between olfactory dysfunction and disease activity.
LEVEL OF EVIDENCE: III.