视频眼震电图和视频头脉冲检查在急性前庭综合征患者快速定位诊断中的应用效果  

Application effect of video electronystagmography and video head impulse test in the rapid location diagnosis of patients with acute vestibular syndrome

作　　者：古丽波斯坦·买买提艾力[1] 阿孜古丽·图尔逊江[1] 王子源 Gulibositan Maimaitiaili;Aziguli Tuerxunjiang;WANG Ziyuan(Center for Diagnosis and Treatment of Otorhinolaryngology,Xinjiang Uygur Municipal People′s Hospital,Urumqi 830001,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院耳鼻喉诊疗中心,新疆乌鲁木齐市830001

出　　处：《广西医学》2023年第12期1422-1426,共5页Guangxi Medical Journal

基　　金：新疆少数民族科技人才特殊培养计划科研项目(2020D03010)。

摘　　要：目的探讨视频眼震电图和视频头脉冲检查(vHIT)在急性前庭综合征(AVS)患者快速定位诊断中的应用效果。方法选取中枢血管性AVS与前庭外周性AVS患者各149例,分别设为中枢组、外周组。所有患者入院后均进行视频眼震电图检查、vHIT,观察两组患者检测结果差异。结果中枢组的病理性自发眼震、病理性凝视眼震的检出率均高于外周组,位置性眼震的检出率低于外周组(均P<0.05)。中枢组患者的平稳跟踪试验结果、扫视试验结果、静态平衡姿势试验结果的异常率均高于外周组,转椅旋转-急停试验结果异常率低于外周组(均P<0.05);中枢组患者的Ⅲ型曲线、Ⅳ型曲线、扫视欠冲、慢扫视、本体觉异常、反向或垂直眼震的检出率均高于外周组,眼震增益单侧减弱的检出率低于外周组(均P<0.05)。中枢组患者的vHIT异常率、代偿性扫视阳性率均低于外周组,低频前庭眼动反射增益值、视跟踪异常率均高于外周组(均P<0.05)。结论中枢血管性AVS患者具有明显的视眼动系统功能异常,可伴不同程度的前庭脊髓反射功能与前庭眼动系统异常,前庭周围性AVS患者主要为体位相关性自发前庭反应和单侧前庭眼动系统功能异常。视频眼震电图与vHIT可为AVS患者的病变定位诊断提供可靠依据。Objective To explore the application effect of video electronystagmography and video head impulse test(vHIT)in the rapid location diagnosis of patients with acute vestibular syndrome(AVS).Methods A total of 149 patients with central vascular AVS and 149 patients with vestibular peripheral AVS were selected,and they were set as central group or peripheral group,respectively.All patients underwent video electronystagmography and vHIT after admission,and the difference of the test results was observed.Results The detection rates of pathological spontaneous nystagmus and pathological gaze nystagmus in the central group were higher than those in the peripheral group,and the detection rate of positional nystagmus was lower than that in the peripheral group(all P<0.05).The abnormal rates of results of smooth pursuit test,saccade test,and static balance posture test in the central group were higher than those in the peripheral group,and the abnormal rate of the swivel chair rotation-emergency stop test result was lower than that in the peripheral group(all P<0.05).The detection rates of typeⅢandⅣcurve,saccade undershoot,slow saccade,proprioceptive abnormality,reverse or vertical nystagmus in the central group were higher than those in the peripheral group,whereas the detection rate of the gain of nystagmus decreased unilaterally was lower than that in the peripheral group(all P<0.05).The abnormal rate of vHIT and positive rate of compensatory saccade in the central group were lower than those in the peripheral group,and the gain value of low-frequency vestibular ocular reflex,the abnormal rate of visual pursuit were higher than those in the peripheral group(all P<0.05).Conclusion Patients with central vascular AVS have obvious dysfunction of the visual ocular motor system,which may be accompanied by the vestibulo-spinal reflex dysfunction and vestibular ocular motor system abnormality.Patients with vestibular peripheral AVS are mainly posture-related spontaneous vestibular reaction and dysfunction of the unilateral v

关 键 词：急性前庭综合征 视频眼震电图 视频头脉冲检查 中枢血管性 前庭外周性 定位 鉴别诊断 

分 类 号：R764[医药卫生—耳鼻咽喉科]