突发性聋伴眩晕患者的半规管损伤频率特性研究  

Frequency Characteristics of the Semicircular Canals Lesion in Sudden Deafness with Vertigo

作　　者：张圣池[1] 陈太生[2,3] 李姗姗[1] 林鹏[2,3] 

机构地区：[1]天津医科大学-中心临床学院,天津300192 [2]天津市第一中心医院耳鼻咽喉头颈外科 [3]天津市耳鼻咽喉科研究所

出　　处：《听力学及言语疾病杂志》2012年第4期325-329,共5页Journal of Audiology and Speech Pathology

摘　　要：目的评估突发性聋(sudden deafness,SD)伴眩晕患者半规管损伤的频率特征。方法对突发性聋伴眩晕患者124例进行视频头脉冲试验(video head impulse test,vHIT)、摇头试验(head shaking test,HST)和低频冷热试验(caloric test,CT),30例正常人为对照组进行vHIT试验。以vHIT的增益值(video-head impulsetest gain,vHIT-G)、HST诱发摇头眼震(head shaking nystagmus,HSN)和冷热试验单侧半规管反应非对称值(u-nilateral weakness,UW)为指标,分析两组对象三组不同责任半规管的三项试验结果特点及其相互关系。结果正常对照组六个半规管的vHIT-G均符合正态分布,相互间差异无统计学意义(F=0.005,P=1.000);两侧前、水平和后三个半规管平均vHIT-G分别为16.80%±9.80%、16.57%±10.30%、16.52%±11.12%。突聋组的患耳前、水平和后三个半规管vHIT-G分别为22.84%±8.08%、30.17%±11.26%、31.03%±8.90%,均符合正态分布,与对照组相应半规管结果比较,差异均有统计学意义(P值均<0.01);vHIT、HST和CT阳性率分别为37.9%、45.2%和79%,CT分别与HST及vHIT阳性率比较,差异有统计学意义(P值均等于0.000,),vHIT与HST阳性率比较,差异无统计学意义(P=0.246)。在不同UW值区间,HST和vHIT的阳性率随着UW值增加也逐渐增加。结论突发性聋伴眩晕患者多存在半规管损伤,且主要发生在低频区;随着损伤的加重,也可累及半规管的中、高频区。中频HST和高频vHIT不宜用作突聋患者半规管损伤的筛查。Objective To assess the frequency characteristics of the lesioned semicircular canal in sudden deafness（SD） with vertigo. Methods There were 124 sudden deafness（SD） with vestigo patients. All patients re- ceived low, middle and high frequency vestibular function tests including caloric test （CT）, head shaking test （HST） and video head impulse test （vHIT）. Thirty normal persons（control group）received the vHIT. The parame- ters of the unilateral weakness （UW）, head shaking nystagmus （HSN） and video head impulse test gain （vHIT- G） were analyzed with SPSS16.0 software. Results The vaules of vHIT--G of the six semicircular canals in the control group were with normal distribation and thore were no statistical significance among them（F= 0. 005. P= 1. 000）,the vHIT--G averages of both sides of anterior, horizontal and posterior semicircular canals were 16.80± 9.80% ,16.57±10.30% ,16.52±11.12%, respectively;in the study group the vHIT--G of the three canals of the affected side were 22.84±8.08%, 30. 17 ± 11.26 % and 31.03±8. 90%, respectively, in which statistical signifi- cance was detected comparing with those of in the control group （all P=0. 000）. The positive rates of the three tests were 47（37.9%） in vHIT,56（45.2%） in HST and 98（79%） in CT. Significant differences （P= 0. 000） were observed between CT and HST, CT and HST. There was no statistical significance between vHIT and HST（P^0. 246）. In different interval of UW value, the positive rate of HST and vHIT increased along with the increasing of UW value. Conclusion The lesion of semicircular canals was often existed in sudden deafness, and the lesion site was mostly at low frequency range of semicircular canal, when the lesion aggravating, the middle and high frequencies of semicir- cular canal may be involved gradually. Thus the middle and high frequency of HST and vHIT are not appropriate for the screening test of the canal damage in SD.

关 键 词：突发性聋 眩晕 半规管 频率 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]