前庭功能检查对眩晕定位诊断的价值探讨  

The value of vestibular function test for the locating diagnosis of vertigo

作　　者：林细康[1] 季晓林[1] 叶华[1] 严金柱[1] 林芳[1] 

机构地区：[1]福建省级机关医院(福建卫生职业技术学院附属医院)神经内科,福建福州350003

出　　处：《癫痫与神经电生理学杂志》2015年第5期269-273,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：福建卫生职业技术学校院级科研课题（编号：2014-2-4）

摘　　要：目的：根据颈性前庭诱发肌源电位（VEMP）、眼性VEMP、视频眼震电图（VNG）及前庭双温交替试验（ABT）在前庭系统的检测优势，对眩晕的定位诊断价值进行探讨。方法：对60例眩晕患者和60例对照组分别进行颈性VEMP、眼性VEMP、VNG和ABT检测，分析对比两组间检测数据的差异。结果：①病例组和对照组颈性VEMP、眼性VEMP各波潜伏期比较差异有显著意义，但峰间波幅比较差异无显著意义。颈性VEMP、眼性VEMP异常主要见于前庭周围性眩晕。②病例组眼动功能异常率显著高于对照组，主要见于后循环缺血性眩晕（PCIV）。③病例组动态位置试验及ABT异常率显著高于对照组，主要见于良性阵发性位置性眩晕（BPPV）及美尼埃病。结论：颈性VEMP、眼性VEMP及ABT主要检测球囊、椭圆囊及半规管功能，而且，ABT还有分侧定位的作用。眼动功能主要用于PCIV等前庭中枢病变的检测。Objective：To investigate the value of the tocating diagnosis of vertigo through certvical vesibu- lar evoked myogeric potential（VEMP）, ocular VEMP, videonystagmography（VNG） and the alternate bithermal caloric test（ABT） to locting. Methods：To investigate the characteristics of certvical VEMP,ocular VEMP, VNG and ABT by testing 60 patients with vertigo and healthy people and to assess the difference in compaarison with the data of the patients with those in healthy people. Results： （1） There was significant difference lantency Of the certvical VEMP and ocular VEMP between affected ears of the patient group and healthy people. There was no significant difference in amplitude of certvical VEMP and ocular VEMP. certvical VEMP,ocular VEMP a- nomalies mainly appeared in vestibular peripheral vertigo; （2）The rate of eye movement dysfunction of the cases was significantly higher than that of the control group, mainly in PCIV; （3）The abnormal rates of the dynamic position and BT of the case group were significantly higher than those in the control group, mainly in BPPV and MD. Conclusion： CVEMP, ocular VEMP and ABT mainly investigate balloon, utricle and semicircular canal func- tion,moreover, ABT has the effect of lateral positioning. Eye movement function is mainly used for central ves- tibular lesion detection, such as PCIV.

关 键 词：眩晕 前庭功能 前庭诱发肌源电位(VEMP) 眼震电图(VNG) 前庭双温交替试验(ABT) 

分 类 号：R441.2[医药卫生—诊断学] R741.044[医药卫生—临床医学]