高龄老人前庭功能、平衡功能、视动功能的定量评价(英文)  

Quantitative evaluation of vestibular function, balance function and optokinetic function in elderly person

作　　者：赵承军[1] 张素珍[1] 

机构地区：[1]解放军总医院耳鼻咽喉科,北京市100853

出　　处：《中国临床康复》2005年第23期231-233,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:80岁以上老年人眩晕及跌倒发生率高,且与位、听、视功能减退有关。目的:定量评价80岁以上老年人的位、听、视功能。设计:以老年患者为观察对象,定量评价其位功能(前庭平衡功能)、听功能(语频听阈)、视功能(视动功能)。单位:解放军总医院耳鼻咽喉科。对象:选择1993-03/1994-01解放军总医院康复部因全身系统疾病住院的老年男性41人,年龄80～94岁。有耳鸣症状者12人,有眩晕症状者20人。选择同期本院健康体检60～79岁健康老干部作为对照,男11例,女7例。该组患者均无耳鸣、耳聋等耳部症状及眩晕症状。所有老年人均自愿参加。方法:对患者进行耳鼻喉全面检查。听功能检查包括纯音测听及脑干电反应测听。前庭功能(位功能)用旋转检测试前庭眼反射,1°/s角加速到90°/s后恒速旋转至眼震消失后骤停记录旋转后眼震,先向左转间隔10min后向右转,计算慢相角速度并计算左右不对称比值;前庭脊髓反射(位功能,VSR)用平衡台测试,并计算人体重心晃动的轨迹长度和速度。视动中枢检查(视功能)用光标测试,包括扫视、跟踪、视动3项眼动功能。主要观察指标:语频听阈、前庭眼反射试验、前庭脊髓反射试验及视动功能检查>80岁老年人位、听、视功能结果,并与60～79岁老年人平衡功能、视动功能检查结果进行对比。结果:按实际处理分析,进行语频听阈、前庭眼反射、前庭脊髓反射、平衡功能和视动功能检查的80岁以上老年人分别为41,24,39,40和34人,进行平衡功能和视动功能检查的60～79岁老年人分别为18和10人,脱落者为不愿接受该项检查者。①听功能:80岁以上老年人41人中语频听阈正常者13耳(16%),听力下降者69耳(64%)。②位功能:前庭眼反射正常者15人(62%),异常者9人(38%),前庭脊髓反射正常10人(26%),异常29人(74%)。③平衡功能:人体平衡功能各参数中以重心晃动的轨�BACKGROUND: Old people above 80 years old have a high incidence of dizziness and tumble, which are associated with weakening vestibular function, balance function and optokinetic function. OBJECTIVE: This study was designed to make a quantitative evaluation of vestibular function, balance function and optokinetic function in people over 80 years old. DESIGN: It was a quantitative study on posture function (vestibular and balance function), auditory function (frequency audiometry) and visual function (optokinetic function) in elderly persons. SETTING: Department of Otolaryngology ,General Hospital of Chinese PLA. PARTICIPANTS: Totally 41 old male inpatients with systemic diseases in Rehabilitation Department of the General Hospital of Chinese PLA, with an age from 80 to 94 were selected from March 1993 to January 1994. Of them, 12 had tinnitus, 20 had dizziness. During the same period, old cadres including 11 males and 7 females aged from 60 to 79 years with normal findings of physical examinations were selected as controls. No participant in this group suffered from tinnitus, deafness and dizziness. All the participants were voluntary. METHODS: Patients underwent full-scale otolaryngological examinations. Audiometry consisted of battery of tests including frequency audiometry and evoked auditory brainstem responses (ABR). Vestibular function (posture) was assessed by vestibular-ocular reflexes. Participants accelerated from 1°/s to 90°/s. Then, the angular speed was kept until the nystagmus disappeared, at the time a sudden stop was made. Changes in nystagmus during the tests were recorded. The eyes firstly turned to left and 10 minutes later turned to right. Slow-phase angular velocity was recorded and the imbalanced left/right rate was calculated. Vestibular-spinal reflex (VSR) was measured using balance beam and the length of the sway of the center of gravity (CG) and the sway velocity of CG were all calculated. Balance tests using a cursor were employed to examine the central optokinetic system, including s

关 键 词：前庭/病理生理学 前庭功能试验 衰老 体位 眩晕/病理生理学 

分 类 号：R592[医药卫生—老年医学]