视频头脉冲试验联合冷热试验评估半规管功能的初步研究  

A Preliminary Study on Semicircular Canal Function Assessment by Video Head Impulse Test and Caloric Test

作　　者：岑锦添[1] 张姝琪 袁涛[1] 梁茵菲 曾祥丽[1] CEN Jintian;ZHANG Shuqi;YUAN Tao;LIANG Yinfei;ZENG Xiangli(Department of Otorhinolaryngology Head and Neck Surgery,Third Affiliated Hospital,Sun Yat-Sen University（Guangzhou,510630,China)

机构地区：[1]中山大学附属第三医院耳鼻咽喉头颈外科

出　　处：《中华耳科学杂志》2018年第3期267-271,共5页Chinese Journal of Otology

基　　金：广州市科技计划项目(No.201709010036)支持~~

摘　　要：目的分析视频头脉冲试验(vHIT)与冷热试验在常见眩晕疾病的特征,探讨其在半规管功能评估中的作用。方法对耳鼻喉科常见眩晕患者(良性阵发性位置性眩晕、梅尼埃病、前庭神经炎、前庭性偏头痛、突发性聋伴眩晕)行冷热实验及视频头脉冲试验,分析比较其结果参数。结果共收集82例病人资料,梅尼埃病25例、良性阵发性位置性眩晕20例、突发性聋伴眩晕14例、前庭性偏头痛12例、前庭神经炎11例。82例病人冷热试验与vHIT总的异常率分别为64.6%、72.0%,半规管总异常率为82.9%,配对四格表卡方检验两者无统计学差异(P=0.307);其中44例冷热试验与vHIT均异常,冷热试验正常而vHIT异常15例,冷热试验异常而vHIT正常9例。梅尼埃病vHIT异常率为56.0%,冷热试验异常率为60.0%,其中12例两者均异常,冷热试验正常而vHIT异常2例,冷热试验异常而vHIT正常3例。BPPV的vHIT异常率为85.0%,冷热试验异常率为65.0%,其中11例两者均异常,冷热试验正常而vHIT异常6例,冷热试验异常而vHIT正常2例。突发性聋伴眩晕vHIT异常率为78.6%,冷热试验异常率为57.1%,其中8例两者均异常,冷热试验正常而vHIT异常3例,冷热试验异常而vHIT正常0例。前庭性偏头痛vHIT异常率为50.0%,冷热试验异常率为66.7%,其中4例两者均异常,冷热试验正常而vHIT异常2例,冷热试验异常而vHIT正常4例。前庭神经炎vHIT异常率为100%,冷热试验异常率为81.8%,其中9例两者均异常,冷热试验正常而vHIT异常2例,冷热试验异常而vHIT正常0例。各组间vHIT异常率有统计学差异(P=0.015),冷热试验异常率无统计学差异(P=0.732)。vHIT尚发现6例梅尼埃病及7例BPPV患者对侧半规管功能异常。结论视频头脉冲试验联合冷热试验能提高半规管功能受损的检出率,应联合运用视频头脉冲试验与冷热试验对半规管功能进行较全面的检查;视频头脉冲试验尚可发现梅尼埃病及BPPV对侧�Objective To investigate characteristics of video head impulse test （vHIT） and caloric test manifesta-tions in common vertigo diseases, and their roles in assessing semicircular canal function. Methods Caloric test and vHIT were conducted in 82 patients with common vertigo diseases, including benign paroxysmal positional vertigo （BP-PV, n=20）, Meniere＇s disease （MD, n=25）, vestibular neurolabyrinthitis （VN, n=11）, vestibular migraine （VM, n=12） and sudden deafness with vertigo （SD, n=14））. The results of these tests were analyzed and compared. Results For the 82 patients, the rate of abnormal results was 64.6%for caloric test and 72.0%for vHIT, respectively （P=0.307）. The rate of abnormal semicircular canal function was 82.9%, with both tests showing abnormal results in 44 patients, normal ca- loric test and abnormal vHIT in 15 patients, and abnormal caloric test but normal vHIT in 9 patients. The rate of abnor-mal vHIT and caloric tests was 56.0%and 60.0%, respectively, for MD （both tests abnormal in 12 patients, normal calor-ic test/abnormal vHIT in 2, and abnormal caloric test/normal vHIT in 3 patients）, 85.0%and 65.0%for BPPV （both tests abnormal in 11 patients, normal caloric test/abnormal vHIT in 6, and abnormal caloric test/normal vHIT in 2 patients）, 78.6%and 57.1%for SD （both tests abnormal in 8 patients, normal caloric test/abnormal vHIT in 3, and abnormal calor-ic test/normal vHIT in none）, 50.0%and 66.7%for VM （both tests abnormal in 4 patients, normal caloric test/abnormal vHIT in 2, and abnormal caloric test/normal vHIT in 4 patients）, and 100.0%and 81.8%for VN （both tests abnormal in 9 patients, normal caloric test/abnormal vHIT in 2, and abnormal caloric test/normal vHIT in none）, respectively. The rate of abnormal vHIT was different among groups （P=0.015）, but not that of caloric test （P=0.732）. vHIT showed ab-normal contralateral semicircular canal function in 6 MD and 7 BPPV patients. Conclusions Combining vHIT and calor-ic test can im

关 键 词：视频头脉冲试验 冷热试验 半规管功能 眩晕 

分 类 号：R764[医药卫生—耳鼻咽喉科]