双温试验中不同刺激顺序下眼震强度比较  

Comparison of the maximum slow-phase velocity with different stimulated sequence

作　　者：马鑫[1] 余力生[1] 李蔷[1] 

机构地区：[1]北京大学人民医院耳鼻咽喉科,北京100044

出　　处：《中国耳鼻咽喉头颈外科》2008年第3期134-136,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家"十一五"攻关资助项目(2007AA02Z498)

摘　　要：目的比较双温试验中不同的冷、热刺激顺序下冷、热气刺激引起的眼震强度的不同。方法对40例正常对照者和自2004～2006年来我院就诊的229例有眩晕主诉的患者,随机分为两组,先冷后热刺激组包括20例正常对照者和101例患者,刺激顺序是①右冷,②左冷,③右热,④左热。先热后冷刺激组包括20例正常对照者和128例患者,刺激顺序是①右热,②左热,③右冷,④左冷。取眼震最强的10秒钟计算眼震最大慢相速度;眩晕患者按照半规管轻瘫指数(canal paresis,CP)≥20%为标准,分为半规管功能正常组和半规管轻瘫组,比较各组不同刺激顺序下冷、热气刺激引起的眼震强度。结果正常对照者先热后冷刺激组,右耳的冷、热气刺激引起的眼震强度无差异,其余各组比较耳冷、热气刺激引起的眼震强度差别有明显统计学意义,而且优先刺激者眼震强。对第1次刺激耳的眼震强度进行比较,正常对照者和半规管轻瘫的眩晕患者眼震强度无差异,而半规管功能正常的眩晕患者热气刺激引起的眼震强。结论双温试验中冷、热气刺激引起的眼震强度相似;不同的刺激顺序对于冷、热气刺激引起的强度有影响,优先刺激者引起的眼震强;正常人中,冷气优先刺激引起的眼震强度明显强,前庭适应更加明显。OBJECTIVE Comparison of the maximum slow-phase velocity of cold and warm air with different stimulated sequence. METHODS Forty normal cases and 229 vertigo cases with bithermal caloric testing during 2004 to 2006 were randomly divided into two groups： 20 normal cases and 101 vertigo cases were stimulated with cold air first, and the other cases with warm air first. According to the canal paresis （CP） ≥20 %, each patients group was subdivided into the normal semicircular canal （SC） function group and the paresis SC function group. The maximal slow-phase velocity （MSV） during the strongest 10 seconds was counted, and compared among the subgroups. RESULTS Except the normal cases with warm air first, the differences between the subgroups were statistically significant. The cold air first group presented stronger MSV with cold air and the warm air first group presented stronger MSV with warm air. CONCLUSION The MSV stimulated by warm air was as the same as that stimulated .by the cold air. With different stimulated sequence, the first stimulation induced stronger response. In normal cases, the cold air firstly stimulated induced much more vestibular adaption.

关 键 词：前庭功能试验 反射 前庭眼 冷热试验 

分 类 号：R764[医药卫生—耳鼻咽喉科]