摘要
目的观察病毒感染后嗅觉障碍(postviral olfactory dysfunction,PVOD)患者和慢性鼻窦炎(CRS)伴嗅觉障碍患者的情绪障碍状况,比较这两种疾病导致的嗅觉障碍引起的患者情绪障碍是否有差异及相关影响因素。方法自2020年11月~2021年8月在中日友好医院耳鼻咽喉头颈外科,对门诊的PVOD患者(n=20)和住院的CRS伴嗅觉障碍患者(n=43)进行研究。收集患者的年龄、性别、病程、发病方式等人口学和临床资料,采用鼻腔鼻窦结局测试-22(sino-nasal outcome test-22,SNOT-22)、T&T嗅觉功能测试、Zung焦虑自评量表(self-rating anxiety scale,SAS)和Zung抑郁自评量表(self-rating depression scale,SDS)分别评估患者的鼻部症状、嗅觉功能、焦虑和抑郁状态。结果PVOD患者的平均SNOT-22评分、嗅觉察觉阈及嗅觉识别阈分值均低于CRS伴嗅觉障碍患者(17.64±6.42 vs 30.42±12.08、1.58±3.42 vs 3.40±3.52和3.58±3.07 vs 2.16±3.51)(P均<0.05),但PVOD患者焦虑抑郁状态的百分比、SAS评分和SDS评分均高于CRS伴嗅觉障碍患者(45%vs 14%、49.83±6.59 vs 43.97±4.50、52.21±7.83 vs 46.40±9.50)(P均<0.05)。PVOD和CRS伴嗅觉障碍患者出现轻度焦虑的百分比分别为45.0%和11.63%,轻度抑郁分别为20%和11.63%,中度抑郁百分比分别为20%和2.33%,焦虑且抑郁分别为30%和2.33%。PVOD患者中多数患者病程<3个月(75%)、多为突然发病(85%)、鼻腔通气情况多为良好(85%),而CRS伴嗅觉障碍患者中多数患者病程>24个月(65.1%)、发病方式多为缓慢发病(76.7%)、鼻腔通气情况多数为差(69.8%);PVOD患者SNOT-22评分与SDS评分呈正相关(P<0.05),与SAS评分无显著相关性,CRS伴嗅觉障碍患者SNOT-22评分与SAS、SDS评分均呈正相关(P<0.05),两种疾病与T&T评分、性别、发病方式及鼻部通气情况均无显著相关性。将PVOD和CRS伴嗅觉障碍患者(n=63)汇集在一起进行Logistic多元回归分析发现嗅觉障碍病程与SAS和SDS评分均呈负相关(P<0.05);SNOT-22评分与SAS和SDS评分均呈正相关(P<0.01);年龄与SAS评分呈正相关(P<0.05),与SDS无显著相关性。结论相较于CRS伴嗅觉障碍患者,PVOD患者SAS、SDS评分以及出现焦虑抑郁状态百分比更高,病程、年龄和SNOT-22评分可能会影响嗅觉障碍患者的焦虑抑郁状态。
OBJECTIVE To compare the anxiety and depression status and analyze related influencing factors in patients with anosmia secondary to viral infection and accompanied with chronic sinusitis.METHODS A prospective cohort study was conducted from November 2020 to August 2021 in the Department of Otolaryngology Head and Neck Surgery,China-Japan Friendship Hospital.Twenty patients with postviral olfactory dysfunction(PVOD)were recruited from outpatient and 43 anosmia patients with chronic rhinosinusitis(CRS)were recruited from the rhinology ward.Demographic and clinical data such as age,sex,course of disease and mode of onset were collected.Clinical nasal symptoms,olfactory function,anxiety and depression were assessed by Nasal sinus outcome Test-22(Sino-Nasal Outcometest-22,SNOT-22),T&T nasal olfactory function test,the Zung's self-rated anxiety scale(SAS)and the Zung's self-rating depression scale(SDS).RESULTS The mean SNOT-22 score,olfactory detection threshold and olfactory recognition threshold of PVOD patients were lower than those of CRS patients with olfactory dysfunction(17.64±6.42 vs 30.42±12.08,1.58±3.42 vs 3.40±3.52 and 3.58±3.07 vs 2.16±3.51)(P<0.05).However,the percentage of anxiety and depression,SAS score and SDS score of PVOD patients were higher than those of CRS patients with olfactory dysfunction(45%vs 14%,49.83±6.59 vs 43.97±4.50,52.21±7.83 vs 46.40±9.50)(P<0.05).The percentage of patients with mild anxiety,mild depression,moderate depression,anxiety and depression were 45.0%and 11.63%,20%and 11.63%,20%and 2.33%,30%and 2.33%,respectively.Among PVOD patients,the course of disease was less than 3 months(75%),the onset mode was mostly sudden onset(85%),and nasal ventilation was generally good(85%).In CRS patients with olfactory dysfunction,the course of disease was longer than 24 months(65.1%),the onset was slow(76.7%),and the nasal ventilation was poor(69.8%).SNOT-22 scores were positively correlated with SDS score in PVOD patients(P<0.05),but not with SAS scores.SNOT-22 score was positively correlated with SAS and SDS score in CRS patients with anosmia(P<0.05).There was no significant correlation between T&T score,gender,mode of onset and nasal ventilation.Logistic multiple regression analysis of PVOD and CRS patients with anosmia(n=63)showed that the course of anosmia was negatively correlated with SAS and SDS scores(P<0.05).SNOT-22 score was positively correlated with SAS and SDS score(P<0.01).Age was positively correlated with SAS score(P<0.05),but not with SDS.CONCLUSION Compared with CRS patients with olfactory dysfunction,PVOD patients had higher rates of anxiety and depression and SAS and SDS scores.The course of disease,age and SNOT-22 score may affect the anxiety and depression of patients with olfactory dysfunction.
作者
樊冰倩
游芳佳
刘梦帆
廖娟
王艺贝
刘剑锋
FAN Bingqian;YOU Fangjia;LIU Mengfan;LIAO Juan;WANG Yibei;LIU Jianfeng(Beijing University of Chinese Medicine,Beijing,100029,China;Department of Otolaryngology Head and Neck Surgery,China-Japan Friendship Hospital,Beijing,100029,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2022年第6期341-345,共5页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
北京市自然科学基金(7212090)。
关键词
鼻窦炎
嗅觉障碍
焦虑
抑郁
病毒感染
Sinusitis
Olfaction Disorders
Anxiety
Depression
virus infections
