首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (2): 375-381.doi: 10.3969/j.issn.1006-7795.2026.02.020

• 临床研究 • 上一篇    下一篇

长期嗅觉丧失患者神经精神症状特征及影响因素分析

姚淋尹1,孙智甫1,郭怡辰1,王建宏1,谷庆隆2,仪晓立3*   

  1. 1.首都医科大学附属北京安贞医院耳鼻咽喉头颈外科，北京 100029; 2.首都医科大学附属首都儿童医学中心耳鼻咽喉头颈外科，北京 100020; 3.首都医科大学附属首都儿童医学中心放射科，北京  100020
  • 收稿日期:2025-10-15 修回日期:2026-02-25 出版日期:2026-04-21 发布日期:2026-04-21
  • 通讯作者: 仪晓立 E-mail:xiaoli_yi@126.com
  • 基金资助:
    首都儿科研究所课题项目（JHYJ-2025-02）。

Characteristics and influencing factors of neuropsychiatric symptoms in patients with persistent olfactory loss

Yao Linyin1,  Sun Zhifu1,  Guo Yichen1,  Wang Jianhong1,  Gu Qinglong2,  Yi Xiaoli3*   

  1. 1.Department of Otolaryngology Head and Neck Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing  100029, China; 2.Department of Otolaryngology Head and Neck Surgery, Capital Center for Childrens Health, Capital Medical University, Beijing  100020, China;3.Department of Radiology, Capital Center for Childrens Health, Capital Medical University, Beijing 100020, China
  • Received:2025-10-15 Revised:2026-02-25 Online:2026-04-21 Published:2026-04-21
  • Supported by:
    This study was supported by Research Foundation of Capital Institute of Pediatrics (JHYJ-2025-02).

PDF

24

摘要： 目的  探究长期嗅觉丧失（persistent olfactory loss, POL）患者神经精神症状的发生情况，并分析其影响因素。方法  自2023年7月至2025年6月期间于首都医科大学附属北京安贞医院嗅觉味觉障碍诊疗中心就诊的POL患者为研究对象。收集患者的年龄、性别、病因、病程等人口学和临床资料，通过Sniffin' Sticks嗅觉测试、焦虑自评量表（Self-Rating Anxiety Scale, SAS）、抑郁自评量表（Self-Rating Depression Scale, SDS）、蒙特利尔认知评估量表（ Montreal Cognitive Assessment, MoCA）和匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index, PSQI）评估患者嗅觉功能、焦虑和抑郁状态、认知能力及睡眠质量。所有受试者进行脑结构磁共振成像（magnetic resonance imaging, MRI）扫描，用基于感兴趣区（region of interest, ROI）的方法提取双侧海马和杏仁核体积。以单因素及多因素Logistic回归分析筛选影响因素，通过受试者工作特征（receiver operating characteristic,ROC）曲线验证影响因素的预测价值。结果  共纳入84例POL患者，焦虑、抑郁、认知障碍及失眠发生率分别为46.43%、32.14%、26.19%和9.52%。单因素分析结果显示，病因、海马体积及杏仁核体积与POL患者神经精神症状的发生显著相关（P<0.05）。多因素Logistic回归分析结果显示，海马体积（OR=0.763, 95%CI=0.622~0.932）和杏仁核体积（OR=0.786, 95% CI=0.656~0.979）是POL患者发生神经精神功能障碍的保护性因素（P<0.05）。ROC曲线下面积（area under curve, AUC）显示，海马体积（AUC=0.874，95% CI=0.802~0.946）和杏仁核体积（AUC=0.912，95% CI=0.852~0.973）对于POL患者神经精神症状的发生均具有预测价值。两者联合预测POL患者发生神经精神功能障碍的AUC为0.944（95% CI=0.898~0.989），灵敏度为88.9%，特异度为87.2%。结论  POL患者焦虑抑郁发生率相对较高，海马及杏仁核体积缩小是POL患者发生精神神经症状的重要影响因素。在临床实践中，对于合并海马和杏仁核萎缩的POL患者，应高度重视其神经精神状态的评估与随访。

关键词: 嗅觉丧失, 焦虑, 抑郁, 磁共振成像, 海马, 杏仁核

Abstract: Objective  To investigate the prevalence of neuropsychiatric symptoms in patients with persistent olfactory loss (POL) and analyze the influencing factors.Methods  Patients diagnosed with POL at the Smell and Taste Disorder Clinic of Beijing Anzhen Hospital, Capital Medical University, from July 2023 to June 2025 were enrolled. Demographic and clinical data, including age, sex, etiology, and disease duration, were collected. Olfactory function was assessed using the Sniffin' Sticks test, while anxiety and depression were evaluated with the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), respectively. Cognitive function and sleep quality were measured using the Montreal Cognitive Assessment (MoCA) and Pittsburgh Sleep Quality Index (PSQI). All participants underwent structural magnetic resonance imaging scans, and volumes of the bilateral hippocampus and amygdala were extracted using a region of interest (ROI)-based approach. Univariate and multivariate Logistic regression analyses were performed to identify influencing factors, and receiver operating characteristic (ROC) curves were used to evaluate the predictive value of these factors.Results  A total of 84 POL patients were enrolled in the study. The prevalence rates of anxiety, depression, cognitive impairment, and insomnia were 46.43%, 32.14%, 26.19%, and 9.52%, respectively. Univariate analysis revealed that etiology, hippocampal volume, and amygdala volume were significantly associated with the occurrence of neuropsychiatric symptoms (P<0.05). Multivariate Logistic regression analysis indicated that hippocampal volume (OR=0.763, 95% CI=0.622-0.932) and amygdala volume (OR=0.786, 95% CI=0.656-0.979) were protective factors against neuropsychiatric dysfunction in POL patients (P<0.05). The area under the curve (AUC) of ROC analysis showed that both hippocampal volume (AUC=0.874, 95% CI=0.802-0.946) and amygdala volume (AUC=0.912, 95% CI=0.852-0.973) had predictive value for neuropsychiatric symptoms. The combination of these two factors achieved an AUC of 0.944 (95% CI=0.898-0.989), with a sensitivity of 88.9% and specificity of 87.2%.Conclusion  POL patients exhibit a relatively high prevalence of anxiety and depression. Reduced volumes of the hippocampus and amygdala are significant influencing factors for neuropsychiatric symptoms in POL patients. In clinical practice, special attention should be paid to the assessment and follow-up of neuropsychiatric status in POL patients with atrophy of the hippocampus and amygdala.

Key words: olfactory loss, anxiety, depression, magnetic resonance imaging, hippocampus, amygdala

中图分类号: 

网站版权所有 © 《首都医科大学学报》编辑部
地址：北京市丰台区右安门外西头条10号　邮编：100069
电话：010-83911346　 Email：xuebao@ccmu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发　技术支持：support@magtech.com.cn
京ICP备10013688号-1