正弦谐波加速试验的正常参考值及初步临床应用  

Normative data and clinical practice of sinusoidal harmonic acceleration test

作　　者：王武庆[1] 迟放鲁[1] 吴琍雯[1] 卢华曾[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科,上海200031

出　　处：《中华耳鼻咽喉头颈外科杂志》2010年第1期14-18,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：上海市卫生局科研基金（200609）

摘　　要：目的测量正弦谐波加速试验的正常参考值和常见疾病的参数值，探讨各检测参数值的临床意义。方法正常人120例，梅尼埃病患者21例，双侧外周前庭病变2例，急性单侧前庭功能受损15例，中枢病变10例，全部完成正弦谐波加速试验。结果年龄大者的定标平均时间长。相位值随频率升高而降低，增益随频率升高而变大，低频相位值重复性好。梅尼埃病患者中7例在间歇期都正常，14例发作末期的患者均有异常，11例相位异常，3例增益异常，10例有不对称，8例患者合并2项指标的异常，不对称的患者均有自发性眼震。单侧急性前庭功能受损患者出现相位异常的11例；增益降低10例，见于0．08Hz以上频段；不对称的有6例，其中5例有自发性眼震。双侧前庭功能受损的患者增益显著降低。中枢损伤10例中相位异常7例，低增益2例，不对称有4例，不对称者均无自发性眼震。结论正弦谐波加速试验的正常参考值在一个比较窄的范围内，相位是其最重要的指标。Objective To establish the normative data of sinusoidal harmonic acceleration test （SHAT） and evaluate the ralue of clinical application. Methods One hundred and twenty normal persons, 21 Meniere＇s disease patients, 2 bilateral vestibular peripheral lesion patients, 15 unilateral vestibular peripheral lesion patients and 10 central lesion patients were tested with SHAT. Results The calibration time was longer in the older persons. The phase decreased with the frequency, and the gain increased with the frequency, but the reliability of the re-test of the phase was better in the lower frequency. The results of the 7 Meniere＇s disease patients without symptoms were normal, 14 patients post-attack revealed abnormal, 11 had phase abnormal, 3 had gain decrease, 10 revealed asymmetry and spontaneous nystagmus simultaneously, 8 patients had two parameters abnormal. The unilateral vestibular peripheral lesion patients showed 73% （11/15） phase abnormal, 67% （ 10/15 ） gain decrease and 40% （6/15） asymmetry, while 5/6 asymmetry patients had spontaneous nystagmus. The gain of the bilateral vestibular peripheral lesion patients showed severe decrease. The abnormal rate in central lesion patients were 70% （7/10） in phase, 20% （2/10） in gain and 40% （4/10） in asymmetry, but the patients with asymmetry had no spontaneous nystagmus. Conclusions The normal range of the phase, gain and asymmetry of SHAT is in anarrow bandwidth. The phase is the most important abnormal sign.

关 键 词：前庭功能试验 迷路疾病 参考值 眼震 病理性 

分 类 号：R764[医药卫生—耳鼻咽喉科]