良性阵发性位置性眩晕患者前庭自旋转试验检查结果分析及其诊断价值探讨  

Application of vestibular autorotation test in diagnosis of benign paroxysmal positional vertigo

作　　者：高波[1] 宋海涛[1] 周金梅[1] 黄魏宁[1] 

机构地区：[1]卫生部北京医院耳鼻咽喉科,北京100073

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第19期865-869,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨前庭自旋转试验(VAT)在评估良性阵发性位置性眩晕(BPPV)患者的前庭功能状况和诊断价值中的作用。方法:对41例BPPV患者分别进行VAT和红外视频眼震图的各项检查。根据受累半规管分组分析VAT的特点。结果:VAT异常者34例(82.93%)。21例垂直半规管BPPV患者中,垂直相移异常14例次,垂直增益异常1例次;水平相移异常6例次,水平增益异常5例次,非对称性异常2例次。12例水平半规管BPPV患者中,水平相移异常6例次,水平增益异常5例次,非对称性异常2例次;垂直相移异常4例次,垂直增益异常2例次。所有患者在相移指标上,4例表现全频段异常,21例在2～3Hz显示异常。冷热试验半规管麻痹(CP)和(或)眼震优势偏向(DP)异常者24例(58.54%),其中4例患者2项指标同时异常。结论:VAT能够全面地了解BPPV患者水平及垂直半规管功能。VAT检测中的相移异常是BPPV的一个相对恒定的表现,并且通常表现在2～3Hz频率上。VAT和冷热试验可互为补充,联合应用有助于全面了解半规管功能。Objective：The objective of this study was to evaluate the utility of vestibular autorotation test in the diagnosis of BPPV.Method：VAT and caloric test were performed on 41patients with BPPV.VAT results were analyzed according to the affected semicircular canal.Result：Results of VAT were abnormal in 34（82.93%） patients with BPPV.Fourteen cases were found with abnormal vertical phase,1case with abnormal vertical gain in a total of 21vertical semicircular canal BPPV patients.Six cases with abnormal horizontal phase lead,5cases with abnormal horizontal gain,2cases with asymmetry were found in 12patients with horizontal semicircular canal BPPV.Phase lead was abnormal in all frequencies in 4patients,and in 2-3Hz in 21patients.24（58.54%）patients showed abnormal canal paresis（CP）and direction preference（DP）in caloric test.Conclusion：VAT can indicate information of vestibular function in both vertical and horizontal semicircular canal.Phase of VAT is constantly enhanced in BPPV,especially in 2-3Hz.As the supplement of caloric test,VAT may prove helpful in assessement of semicircular canal function.

关 键 词：眩晕 前庭自旋转试验 变位试验 冷热试验 

分 类 号：R441.2[医药卫生—诊断学]