温度试验双侧前庭功能减弱患者视频头脉冲测试表现  

Performance of video head impulse test in patients with bilateral vestibular weakness in the caloric test

作　　者：胡佳佳 王翠翠 佟加宝 巩丰媛 金占国 贾宏博 HU Jiajia;WANG Cuicui;TONG Jiabao;GONG Fengyuan;JIN Zhanguo;JIA Hongbo(Vertigo Clinic/Research Center of Aerospace Medicine,Air Force Medical Center,Air Force Medical University,Beijing 100142;Dujiangyan Special Crew Sanatorium of PLA Air Force,Dujiangyan 611830;The hospital of No.93665 Troops of PLA;Air Force Medical Center,Air Force Medical University,Beijing 100142,China)

机构地区：[1]空军军医大学空军特色医学中心眩晕诊疗研究中心,北京100142 [2]空军都江堰特勤疗养中心,都江堰611830 [3]解放军93665部队医院 [4]空军军医大学空军特色医学中心,北京100142

出　　处：《空军航空医学》2025年第1期28-31,共4页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的深入分析经温度试验证实为双侧前庭功能减弱(bilateral vestibular weakness,BVW)患者的视频头脉冲测试(video head impulse test,vHIT)数据,探讨vHIT在BVW诊断中的替代作用。方法回顾性收集空军特色医学中心眩晕诊疗中心106例眩晕患者的前庭检查资料,按温度试验结果将上述患者分为BVW组和前庭功能正常组(对照组),对比分析2组的vHIT表现。结果vHIT水平半规管单侧异常或双侧异常均视为阳性结果时,vHIT与温度试验在检测BVW方面差异有统计学意义(P=0.002);vHIT双侧水平半规管异常视为阳性结果、水平半规管正常视为阴性结果时,vHIT与温度试验在检测BVW方面差异有统计学意义(P=0.019)。扫视频率的受试者操作特征(receiver operator characteristic,ROC)曲线下面积为0.748,灵敏度为60.3%,特异度为87.3%;半规管增益损失量的ROC曲线下面积为0.841,灵敏度为87.2%,特异度为76.1%;增益不对称值的ROC曲线下面积为0.706,灵敏度为87.2%,特异度为43.3%。结论应当优先采用vHIT作为初步筛查患者是否患有BVW的工具,若vHIT检测结果未显示异常,则应进一步进行温度试验以确认诊断,从而确保不会遗漏潜在的BVW病例。Objective To analyze the data on the video head impulse test(vHIT)in patients diagnosed with bilateral vestibular weakness(BVW)via the caloric test in order to explore the alternative role of vHIT in diagnosis of BVW.Methods Data on vestibular examination of 106 vertigo patients was retrospectively collected.The patients were divided into the BVW group and normal vestibular function group(control group)according to the caloric test results.Results of vHIT were compared between the two groups.Results Once either unilateral or bilateral anomalies in the horizontal semicircular canals were deemed positive in a vHIT,statistically significant differences could be observed between vHIT and the caloric test for detecting BVW(P=0.002).Furthermore,when only bilateral anomalies in the horizontal semicircular canals were considered positive,but negative in normal canals,vHIT still remained significantly different from the caloric test in identifying BVW(P=0.019).The area under the ROC curve for saccade frequency was 0.748,the sensitivity 60.3%and specificity 87.3%.As for the semicircular canal gain loss,the area under curve was 0.841,sensitivity 87.2%and specificity 76.1%,compared with 0.706,87.2%and 43.3%for asymmetrical gain.Conclusion vHIT should be prioritized as an initial screening tool for diagnosing BVW.When vHIT results show no abnormalities,a caloric test should be conducted to confirm the diagnosis,thereby ensuring that no potential BVW cases are missed.

关 键 词：前庭功能减弱 视频头脉冲测试 温度试验 

分 类 号：R764[医药卫生—耳鼻咽喉科]