床旁动态视敏度检查在外周前庭病变中的临床意义  

Clinical significance of bedside dynamic visual acuity test

作　　者：王素菊[1,2] 姜鸿[1,2] 高志强[1,2] 吴海燕[1,2] Wang Suju;Jiang Hong;Gao Zhiqiang;Wu Haiyan(Department of Otorhinolaryngology,Peking Union Medical College Hospital,Beijing 100730,China;Chinese Academy of Medical Sciences Peking Union Medical College)

机构地区：[1]中国医学科学院北京协和医学院,100730 [2]北京协和医院耳鼻咽喉科,100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2018年第12期893-897,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家卫生和计划生育委员会保健局保健重点科研项目(W2016ZD03).

摘　　要：目的通过观察床旁动态视敏度(dynamic visual acuity,DVA)检查与冷热试验结果的相关性,探讨DVA在外周性前庭病变诊断中的临床意义。方法回顾性分析2015年2月至2017年6月北京协和医院323例行床旁DVA检查的外周前庭病变患者的临床资料,其中男169例、女154例,年龄18~80岁,平均(53.0±15.2)岁。全部病例均行耳科常规检查、床旁DVA检查以及冷热试验等前庭功能实验室检查。分析床旁DVA结果与冷热试验结果的相关性。结果323例患者中DVA阳性113例,其中109例冷热试验结果符合双侧或单侧前庭功能丧失。构成DVA阳性前三位的疾病分别为双侧前庭病(61例)、前庭神经炎(24例)以及单侧全聋型突发性聋(12例),共占比85.84%(97/113)。结论床旁DVA可以有效发现失代偿的双侧和严重的单侧前庭功能障碍病例,DVA阳性病例多见于双侧前庭病、前庭神经炎以及单侧全聋型突发性聋。床旁DVA简便易行,可作为床旁前庭功能损失筛查的有效评估手段。Objective Dynamic visual acuity (DVA) is defined as the visual acuity when there are relative movements between subjects and visual targets. The purpose of this study was to discuss the correlation between bedside DVA test and other examinations of vestibular function, and to assess the value of DVA test for clinical diagnosis. Methods Retrospective analysis of 323 cases with peripheral vestibular disorder, and analyzing the correlation between bedside DVA results and caloric test were performed. Results Out of these 323 cases, 113 cases showed positive results of DVA.Among these 113 cases with positive DVA test, 109 cases were bilateral or unilateral vestibular function loss according to the results of caloric test or VEMP. The disease with the highest positive rate of DVA was bilateral vestibulopathy(BVP), followed by vestibular neuritis (VN) and profound sudden sensorineural hearing loss (pSSNHL). Conclusions Bedside DVA is effective to determine the cases with BVP and severe unilateral vestibular function loss.

关 键 词：前庭功能试验 反射 前庭眼 动态视敏度 

分 类 号：R764[医药卫生—耳鼻咽喉科]