不同体位下颈前庭诱发肌源性电位的特点  

Characteristics of cervical vestibular evoked myogenic potential in different test positions

作　　者：傅新星[1] 刘博[1] 亓贝尔[1] 姬晨[1] 关静子[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京市耳鼻咽喉科研究所,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),100005

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第9期650-654,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市科技新星项目（Z151110000315064）;首都医科大学附属北京同仁医院科研基金（2014-YJJ-ZZL-012）

摘　　要：目的获得健康青年人不同体位颈前庭诱发肌源性电位（cervical vestibular evoked myogenic potential, cVEMP）的特征参数，探讨测试体位与cVEMP各参数的关系，为选择较适宜临床应用的测试体位提供参考。方法50名健康青年人（男、女各25名，共100耳）在相同的声刺激参数和记录条件下，采用随机函数确定测试顺序后分别于坐姿转颈体位和仰卧抬头体位进行cVEMP测试，记录不同体位条件下cVEMP的引出率，P1、N2潜伏期、幅值、波间期等参数。结果坐位转颈体位和仰卧抬头体位的cVEMP引出率均为100%；坐位cVEMP阈值为（93.5±4.3）dBnHL。坐位cVEMP的P1、N2潜伏期长于卧位，差异具有统计学意义（P值均〈0.05）；P1－N2幅值则小于卧位，差异具有统计学意义（P〈0.05）。坐位测试中P1、N2潜伏期左侧长于右侧（P值分别为0.013和0.015）；卧位测试中P1、N2潜伏期左侧与右侧差异无统计学意义（P值均〉0.05）。坐位耳间幅度比及耳间不对称率较卧位更明显（P值分别为0.009和0.016）。坐位条件下P1－N2幅值男性大于女性，差异具有统计学意义（P＝0.031）；卧位条件下P1－N2幅值男性小于女性，差异具有统计学意义（P＝0.043） 结论测试体位会对cVEMP的结果产生一定影响，临床上可根据受试者条件及测试目的选择更适合的体位。ObjectiveTo investigate the characteristics of cervical vestibular evoked myogenic potential （cVEMP） of normal youth with different test positions, to study the relationship between test positions and test parameters, and to explore the suitable test position for clinical practice. MethodsFifty healthy young volunteers （25 males, 25 females, 100 ears） were enrolled in this study. Two test positions were used, including sitting with the head turned away from the test （SIT） and supine with the head held straight up （SUP）. The derivation rate, latency and amplitude were analyzed. ResultsThe derivation rates of both SIT and SUP were 100%. The VEMP threshold in SIT was （93.5±4.3）dBnHL. The latency of P1 and N2 in SIT was longer than that in SUP, with significant different （P〈 0.05）, the amplitude of P1-N2 in SIT was less than that in SUP, with significant different （P〈 0.05）. Regarding to the latency of P1 and N2 in SIT, the left was longer that right, with （P=0.013） and （P=0.015） respectively. The latency in SUP between sides was not significant （P〉0.05）. The amplitude ratio and asymmetry in SIT were more obvious than in supine position （P=0.009 and 0.016）. In SIT position the P1-N2 amplitude in males was larger than in females, with significant difference （P=0.031）; In SUP position the P1-N2 amplitude in males was less than in females, with significant difference （P=0.043）. ConclusionThe cVEMP can be affected by the different test positions, it is recommended to select a more suitable test position according to the condition of the subject and the purpose of the test.

关 键 词：前庭诱发肌源性电位 体位 球囊和椭圆囊 

分 类 号：R764[医药卫生—耳鼻咽喉科]