视频头脉冲在社区糖尿病患者前庭功能筛查中的应用  

Video Head Pulse Screening in Community Diabetic Patients

作　　者：冯文静 曲静 刘博[2] 杜凤东 李蕾 李元惠 郭亿超 高云海 FENG Wenjing;QU Jing;LIU Bo;DU Fengdong;LI Lei;LI Yuanhui;GUO Yichao;GAO Yunhai(Department of Otolaryngology,First Affiliated Hospital of Tsinghua University,Beijing 100016,China;不详)

机构地区：[1]清华大学第一附属医院耳鼻咽喉科,北京100016 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心、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) [3]北京市朝阳区望京社区卫生服务中心

出　　处：《中华耳科学杂志》2024年第4期548-552,共5页Chinese Journal of Otology

基　　金：北京市朝阳区科技计划项目CYSF2119。

摘　　要：目的探讨视频头脉冲检查技术(video head impulse test,vHIT)在社区糖尿病患者前庭功能筛查中的应用。方法选择北京市朝阳区社区的32例糖尿病患者和32例对照组,应用视频头脉冲检查评估两组的前庭功能。结果糖尿病组和对照组vHIT增益值比较有明显统计学差异(χ^(2)=10.536,P<0.01)。糖尿病组有50%患者出现异常扫视波,其中水平半规管(68.75%)受累最常见。对照组有9.38%患者出现异常扫视波,均为水平半规管受累。两组异常扫视波有明显统计学差异(χ^(2)=14.083,P<0.01)。糖尿病组按是否有前庭症状分组:有前庭症状组:22例(68.75%);无前庭症状组:10例(31.25%)。两组右前、左前和右后半规管vHIT增益值比较,差异有统计学意义(P<0.05)。两组右水平、左水平和左后半规管差异无统计学意义(P>0.05)。有前庭症状组和无前庭症状组异常扫视波无统计学差异(χ^(2)=2.327,P>0.05)。依据糖尿病病程分组,病程≤10年组:13例,病程>10年组:19例。除右侧水平和右侧前半规管外,两组其余半规管vHIT增益值比较差异有统计学意义(P<0.05)。病程≤10年组和病程>10年组异常扫视波有统计学差异(χ^(2)=6.348,P<0.05)。随着糖尿病病程延长,更易出现vHIT异常扫视波。结论应用视频头脉冲检查在社区对糖尿病患者进行前庭功能筛查具有可行性;与对照组相比,糖尿病患者更易出现前庭功能损伤,且水平半规管受累最常见。糖尿病病程与前庭功能损伤有相关性,病程越长,更易发生前庭功能损伤。Objective To report results of video head impulse test(vHIT)vestibular function screening in community diabetic patients.Methods Diabetic patients(n=32)and control subjects(n=32)in Chaoyang District,Beijing,received vestibular function assessment using vHIT.Results Significant differences in vHIT gain between the diabetic and control groups were noticed(χ^(2)=10.536,P<0.01).Abnormal saccades occurred in 50%of the diabetic patients,mostly involving the horizontal semicircular canal(68.75%),compared to only 9.38%of the subjects in the control group showing abnormal saccades,all with horizontal semicircular canal involvement(χ^(2)=14.083,P<0.01).Of the diabetic patients,22(68.75%)had vestibular symptoms and 10(31.25%)did not.vHIT gain showed significant differences for bilateral anterior and right posterior semicircular canals between the two groups(P<0.05),but not for bilateral horizontal and left posterior semicircular canals(P>0.05).Presence of absence of vestibular symptoms had no effects on abnormal saccades(χ^(2)=2.327,P>0.05).Significant differences in vHIT gain were noticed between patients with disease durations≤10 years(n=13)and those with disease durations>10 years(n=19)(P<0.05),with the latter showing more abnormal saccades(χ^(2)=6.348,P<0.05).Conclusion vHIT can be used for vestibular function assessment in the community population.Diabetic patients are prone to vestibular impairment and horizontal semicircular canal involvement is the most common.Prolonged diabetes is associated with increased risks of vestibular function impairment.

关 键 词：糖尿病 视频头脉冲检查 前庭功能 

分 类 号：R587.1[医药卫生—内分泌]