67例单侧梅尼埃病患者视频头脉冲测试结果分析  

Video Head Impulse Test in Patients with Unilateral Meniere’s Disease:A Series of 67 Cases

作　　者：石小玲 龚嘉敏 樊婷 周若峤 尹彦波 王云峰 SHI Xiaoling;GONG Jiamin;FAN Ting;ZHOU Ruoqiao;YIN Yanbo;WANG Yunfeng(Department of Otolaryngology,Eye&Ear Hospital of Fudan University,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中华耳科学杂志》2024年第6期885-889,共5页Chinese Journal of Otology

摘　　要：目的探讨视频头脉冲试验(video head impulse test,vHIT)在梅尼埃病(Meniere’s disease,MD)患者中的应用以及vHIT是否与MD分期相关。方法回顾性选取2021年1月至2022年12月复旦大学附属眼耳鼻喉科医院耳鼻喉科收治的67例单侧MD患者为研究对象,根据听力损失是否>40 dB将患者分为早期组15例和晚期组52例,观察两组增益值和扫视波。结果患侧半规管异常29例,其中前半规管异常1例、水平半规管异常29例、后半规管异常11例。健侧半规管异常13例,其中前半规管异常1例、水平半规管异常11例、后半规管异常4例;患侧半规管异常多于健侧,差异有统计学意义(P<0.001)。患侧水平半规管vHIT增益值低于健侧,增益值降低例数、显性扫视波例数多于健侧,差异均有统计学意义(P<0.05)。患侧前半规管、后半规管vHIT结果与健侧比较,差异无统计学意义(P>0.05)。早期组MRI造影检查阳性率与晚期组比较,差异无统计学意义(P>0.05)。早期组vHIT前半规管、后半规管异常与晚期组比较,差异无统计学意义(P>0.05)。晚期组水平半规管显性扫视波例数多于早期组,差异有统计学意义(P<0.05)。晚期组水平半规管vHIT增益值、增益值降低例数、隐性扫视波例数与早期组比较,差异均无统计学意义(P>0.05)。结论MD较易累及水平半规管,其次为后半规管,前半规管极少出现异常。vHIT水平半规管显性扫视波的出现还与MD分期相关。vHIT有可能成为预测MD分期的有效检测指标。Objective To report Video Head Impulse Test(vHIT)results in patients with Meniere’s Disease(MD)and to assess their potential relationship to MD staging.Methods Data from 67 patients with unilateral MD treated at the Department of Otolaryngology,Fudan EENT Hospital,from January 2021 to December 2022 were retrospective analyzed.Cases were categorized as early(15 cases)or late stage(52 cases)based on hearing loss(>40 dB).vHIT gain and the frequency of overt and covert saccades were compared.Results Among the 67 patients,Involvement of the ipsilateral semicircular canals was implicated in 29 cases,including the anterior semicircular canal(ASC)in 1 case,the horizontal semicircular canal(HSC)in 29 cases,and the posterior semicircular canal(PSC)in 11 cases.Abnormalities of contralateral semicircular canals were implicated in 13 cases,involving the ASC in 1 case,HSC in 11 cases,and PSC in 4 cases.Involvement of ipsilateral semicircular canals was more common than that of contralateral canals(P<0.001).vHIT gain on the affected side was lower than that on the healthy side for the HSC(P<0.05),with higher of overt saccadic frequencies,but not for the ASC and PSC(P>0.05).The rate of positive MRI findings was not significantly different between patients with early and those with late stage MD(P>0.05),as with the rates of vHIT abnormality for the ASC and PSC(P>0.05).However,the rate of overt saccades for the HSC was significantly higher in patients with late stage MD compared to those with early stage MD(P<0.05),despite no significant differences in vHIT gain or covert saccades(P>0.05).Conclusion In patients with MD,abnormalities are more frequently observed in the HSC and PSC,and rarely in the ASC.The presence of overt saccades for the HSC,as measured by vHIT,is associated with MD stage,suggesting that vHIT may serve as an effective diagnostic tool for predicting the stage of MD.

关 键 词：梅尼埃病 视频头脉冲试验 半规管功能 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]