军事飞行员经肌张力修正的前庭诱发肌源性电位参考值  

The reference values of myotonia-corrected vibration vestibular evoked myogenic potentials for military pilots

作　　者：党梓怡 翟丽红 王蒙 金占国 Dang Ziyi;Zhai Lihong;Wang Meng;Jin Zhanguo(Vertigo Clinic/Research Center of Aerospace Medicine,Air Force Medical Center,Air Force Medical University,PLA,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

出　　处：《中华航空航天医学杂志》2024年第4期249-254,共6页Chinese Journal of Aerospace Medicine

摘　　要：目的收集健康军事飞行员经肌张力(electromyogram,EMG)修正的前庭诱发肌源性电位(vestibular evoked myogenic potentials,VEMPs)数据,比较经EMG修正前后VEMPs的双侧振幅、振幅不对称比等相关参数,更加精准地评估飞行员的耳石器及其传导通路的功能。方法选取100名(共200耳)现役健康男性军事飞行员,平均年龄(26.86±6.54)岁,以坐姿进行气导声刺激诱发的颈性前庭诱发肌源性电位(cervical vestibular-evoked myogenic potential,cVEMP)和眼性前庭诱发肌源性电位(ocular vestibular-evoked myogenic potential,oVEMP)测试。使用插入式耳机给声,刺激音为97 dB nHL的短纯音,收集VEMPs的P1、N1潜伏期、P1-N1波间期,以及经EMG修正前后VEMPs的P1-N1振幅、振幅不对称比等参数并进行对比分析。结果VEMPs在飞行员中的引出率为100%。cVEMP的P1、N1潜伏期分别为(15.58±1.29)、(26.12±1.91)ms,波间期为(10.54±1.49)ms,oVEMP的N1、P1潜伏期分别为(11.96±0.92)、(16.92±1.06)ms,波间期为(4.96±0.75)ms。经EMG修正前后的VEMPs振幅差异均有统计学意义(Z=-17.30、-17.30,P均<0.001);修正前后cVEMP的振幅不对称比差异有统计学意义(Z=-2.91,P=0.004),修正前后oVEMP的振幅不对称比差异无统计学意义(P>0.05)。结论本研究建立了军事飞行员经EMG修正后的VEMPs正常范围,为飞行学员医学选拔以及飞行员耳石器及其传导通路的功能评估提供更准确的参考依据。Objective To more accurately evaluate the function of the otolith organ and its conduction pathway of pilots by collecting the vestibular evoked myogenic potentials(VEMPs)corrected by electromyogram(EMG)in healthy military pilots and comparing bilateral amplitude,amplitude asymmetry ratio and other relevant parameters with and without EMG rectification.Methods One hundred(200 ears)healthy male active duty military pilots were selected as study subjects,with an average age of(26.86±6.54)years old.The cervical vestibular-evoked myogenic potential(cVEMP)and ocular vestibular-evoked myogenic potential(oVEMP)induced by air conduction acoustic stimulation were performed to the subjects in sitting position.Sound was delivered through inserted earphones,with the stimulus being tone burst at 97 dB nHL.The P1 latency,N1 latency,P1-N1 wave interval latency,and the P1-N1 amplitude and amplitude asymmetry ratio of VEMPs were recorded before and after the correction of EMG and those were compared and analyzed.Results The evoked rate of VEMPs was 100%.The latency of P1 and N1,P1-N1 interval of cVEMP in these pilots were(15.58±1.29),(26.12±1.91),and(10.54±1.49)ms.The latency of N1 and P1,P1-N1 interval of oVEMP in these pilots were(11.96±0.92),(16.92±1.06),and(4.96±0.75)ms.The difference of VEMPs amplitude before and after EMG correction was statistically significant(Z=-17.30,-17.30,both P<0.001).The difference of amplitude asymmetry ratio of cVEMP before and after correction was statistically significant(Z=-2.91,P=0.004),but the difference of amplitude asymmetry ratio of oVEMP before and after correction was not statistically significant(P>0.05).Conclusions This research sets up the normal range of VEMPs corrected by EMG in military pilots and provides a more accurate reference for medical selection of flying cadets and functional evaluation of the otolith organ and its conduction pathway.

关 键 词：前庭诱发肌源性电位 肌电描记术 前庭功能试验 飞行员 

分 类 号：R85[医药卫生—航空、航天与航海医学]