回顾性分析63例前庭神经炎患者的临床特点  

A retrospective analysis of the clinical characteristics of 63 patients with vestibular neuritis

作　　者：王琦 尹根蒂[1] 张姝琪 黄绮玲[1] 李凌伟 黎志成[1] 曾祥丽[1] WANG Qi;YIN Gendi;ZHANG Shuqi;HUANG Qiling;LI Lingwei;LI Zhicheng;ZENG Xiangli(Department of Otolaryngology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou,510000,China)

机构地区：[1]中山大学附属第三医院耳鼻咽喉头颈外科,广州510000

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第1期19-23,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广州市基础与应用基础项目(No:202201011557)。

摘　　要：目的:回顾性分析63例前庭神经炎患者听觉及前庭功能检查、实验室检查结果并分析其特点。方法:收集2012年10月至2022年12月在中山大学附属第三医院耳鼻咽喉头颈外科住院治疗的资料完整的前庭神经炎患者63例,均符合2022年Bárány协会前庭神经炎的诊断标准,总结纯音测听、耳蜗电图、视频眼震图、双温实验、颈肌前庭诱发肌源性电位(cVEMP)、眼肌前庭诱发肌源性电位(oVEMP)、视频头脉冲试验(vHIT)完成比及异常比。选取年龄性别匹配的体检中心健康体检者63例为对照组,比较2组间血炎症指标及脂代谢指标是否存在差异。结果:前庭神经炎患者纯音测听双耳听力正常50例,双侧高频感音神经性听力下降8例,单侧轻度高频感音神经性听力下降5例。耳蜗电图完成56例,其中双耳-SP/AP幅值比≥0.4为3例,单耳幅值比≥0.4为5例。双温试验完成为55例,且55例CP值均大于30%。vHIT完成30例。cVEMP完成46例,oVEMP完成22例。4项前庭功能检查全部完成17例。可判断损伤范围的患者49例,其中单侧前庭上神经损伤27例,单侧前庭上、下神经损伤21例,单侧前庭下神经损伤1例。前庭神经炎患者血中性粒细胞值(P<0.001)、淋巴细胞值(P<0.005)、中性粒/淋巴细胞比值(P<0.001)、载脂蛋白A1(P<0.001)、胆固醇(P<0.001)、高密度脂蛋白(P<0.01)、低密度脂蛋白(P<0.01)与对照组比较差异有统计学意义。炎症指标是前庭神经炎患者的危险性因素,OR值分别为中性粒细胞值1.81(1.38~2.37,P<0.001)、血中性粒/淋巴细胞比值2.11(1.41~3.16,P<0.001),载脂蛋白A1是前庭神经炎患者的保护性因素,OR值为0.004(0.001~0.042,P<0.001)。结论:部分前庭神经炎患者耳蜗电图结果异常,可能提示患者存在隐性听力损失。中性粒细胞值、淋巴细胞值、血中性粒/淋巴细胞比值、载脂蛋白A1、与前庭神经炎发病相关。其中中性粒细胞值、血中性粒/淋巴细胞比�Objective:To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology,Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University,from October 2012 to December 2022 were recruited.All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis.Clinical data and the results of pure tone audiometry,electrocochleogram,video electronystagmogram,caloric test,cervical vestibuloevoked myogenic potential(cVEMP),ocular vestibuloevoked myogenic potential(oVEMP),video head impulse test(vHIT) was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group.The differences of blood indexs and lipid metabolism indexes between the two groups were compared.Results:In patients with vestibular neuritis,50 out of 63 patients presented normal threshold in pure tone audiometry,8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss,56 out of 63 cases completed the electrocochleogram,of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4,5 cases had monaural amplitude ratio ≥0.4.Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all.The ratio of patients completed cVEMP,oVEMP and vHIT were 46 cases,22 cases and 30 cases,respectively.17 out of 63 cases completed all the four vestibular function tests.According to these tests,49 patients could determine the extent of injury,including 27 cases with unilateral superior vestibular nerve injury,21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury.There were significant differences in neutrophil value(P<0.001),ly

关 键 词：前庭神经炎 中性粒细胞值 胆固醇 高密度脂蛋白 低密度脂蛋白 

分 类 号：R339.17[医药卫生—人体生理学]