速尿对诊断膜迷路积水的临床探讨  

Furosemidetestfordiagnosisofendolymphatichydrops:aclinicalexploration

作　　者：周定蓉[1,2] 徐伟恒[1,2] 何端军[1,2] 甘永莲[1,2] 何凌汉[1,2] 

机构地区：[1]第三军医大学大坪医院耳鼻咽喉科 [2]天津解放军254医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉科杂志》1996年第4期227-230,共4页Chinese Journal of Otorhinolaryngology

摘　　要：为研究速尿试验诊断膜迷路积水的可靠性，对膜迷路积水患者（实验组）及非膜迷路积水的眩晕患者（对照组）各５４例行速尿试验。静脉注射２０ｍｇ速尿，眼震电图（ＥＮＧ）记录用药前后眼震的变化，以用药后眼震最大慢相速度（ＭＳＶ）上升２２．９７％为阳性指标。两组阳性率分别为７０．４％及２５．９％。两组速尿试验阳性患者用药后优势偏向（ＤＰ）阳性率均明显降低，实验组降低率为７７．８％（２１／２７），其中９例降至正常，提示ＤＰ的变化亦有重要意义。全部受试者无１例听功能受损或原症状加重。速尿试验为诊断膜迷路积水的有价值的方法之一。Furosemidetest(FT)isaclinicalmethodforthediagnosisofendolymphatichydrops(EH).Immediatelyprecedingi.vinjectionof20mgfurosemide,acalorictestwasperformedwith50mlofwaterat30°C.Nystagmographywasemployedtomeasurethemaximumslowvelocityofcaloricnystagmus.Thetestwasrepeatedonehouraftertheinjection.Thetwosetsofdatawerethencom-pared.Anincreasebeyond22.97%wasdefinedaspositive.Thefirstgroupwascomposedof54pa-tientsofEHastheexperimentalgroup,andthesecondgroup54patientswithvertigoofnon-EHascontrol.Thepositiveratesofthetwogroupswere70.4%and25.9%respectively.ItshowedthatFTwasusefulfordetectingEH.Thepercentageofdirectionalpreponderance(DP)wasobviouslyde-scendedinthetwogroupsafteri.vfurosemide.Descendingratewas77.8%(21/27)inthefirstgroup,whichhadreachedthenormalvaluein9cases.ItwasshowedthatDPwasimportantalsoforcriticizingFT.Thehearingofalsubjectswasnotdamaged.Whentherenalfunctionofthesubjectwasnormalandnotcombinedwiththeuseofaminoglycosideantibiotics,thedoseofFTwasnotdan-geroustothehearingandhadfewsidereactions.Themechanismofdehydrationinhydropiclabyrinthwaspresumedtobeacutesystemicdiuresis,buttheefectininnerearwasunknown.

关 键 词：内耳眩晕症 膜迷路积水 速尿 诊断 眼震电图 

分 类 号：R764.330.4[医药卫生—耳鼻咽喉科]