中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2011年
5期
382-387
,共6页
刘冉冉%陈太生%林鹏%董红%鲁宏华%张娜
劉冉冉%陳太生%林鵬%董紅%魯宏華%張娜
류염염%진태생%림붕%동홍%로굉화%장나
眩晕%前庭功能试验%冷热试验%半规管%球囊和椭圆囊
眩暈%前庭功能試驗%冷熱試驗%半規管%毬囊和橢圓囊
현훈%전정공능시험%랭열시험%반규관%구낭화타원낭
Vertigo%Vestibular function tests%Caloric test%Semicircular canals%Saccule and utricle
目的 探讨外周单侧前庭功能减退患者的主观视觉水平线特点及其对前庭功能评定的临床价值.方法 分别对85例外周单侧前庭功能减退患者及39名健康对照组人群行主观视觉水平线、主观视觉垂直线及冷热试验等前庭功能检测,以主观视觉水平线及主观视觉垂直线偏斜角度、冷热试验优势偏向(directional preponderance,DP)值、单侧半规管轻瘫(unilateral weakness,UW)值为参数,分析总结外周单侧前庭功能减退患者的主观视觉水平线特点,主观视觉水平线、主观视觉垂直线之间及其分别与DP、UW值、病程的相关性.以SPSS 16.0软件对数据进行统计学分析.结果 健康对照组主观视觉水平线、主观视觉垂直线的偏斜角度为-2,～2.以此为判定阳性与阴性的标准.外周单侧前庭功能减退患者的主观视觉水平线、主观视觉垂直线阳性者分别为46例(54.1%)、43例(50.6%),二者比较差异无统计学意义(χ2=12.5,P=0.481);DP阳性者55例(64.7%),与主观视觉水平线、主观视觉垂直线比较,差异均无统计学意义(χ2值分别为0.19、2.86,JP值分别为0.164、0.067).外周单侧前庭功能减退患者的主观视觉水平线与主观视觉垂直线偏斜角度呈正相关(r=0.939,P<0.01),且二者与DP值均呈正相关(r值分别为0.648、0.658,P值均<0.05),与UW值无相关性(r值分别为0.048、0.085,P值均>0.05).根据主观视觉水平线或主观视觉垂直线、DP、UW3个参数的阳性或阴性组合,可分别构成3种主要结果形式,即:主观视觉水平线(+)DP(+)UW(+),主观视觉水平线(-)DP(+)UW(+),主观视觉水平线(-)DP(-)UW(+);主观视觉垂直线(+)DP(+)UW(+),主观视觉垂直线(-)DP(+)UW(+),主观视觉垂直线(-)DP(-)UW(+).以上6种形式的病程中位数分别为5.0、10.0、15.0 d,5.0、9.5、14.5 d,分别行多样本秩和检验,差异均有统计学意义(χ2水平线:8.80,P=0.012;χ2垂直线=6.26,P=0.040).结论 主观视觉水平线可以评估耳石器(椭圆囊)功能.外周单侧前庭功能减退患者的主观视觉水平线、主观视觉垂直线偏斜角度随病程和前庭代偿进程呈动态变化,可用于前庭静态代偿评定.
目的 探討外週單側前庭功能減退患者的主觀視覺水平線特點及其對前庭功能評定的臨床價值.方法 分彆對85例外週單側前庭功能減退患者及39名健康對照組人群行主觀視覺水平線、主觀視覺垂直線及冷熱試驗等前庭功能檢測,以主觀視覺水平線及主觀視覺垂直線偏斜角度、冷熱試驗優勢偏嚮(directional preponderance,DP)值、單側半規管輕癱(unilateral weakness,UW)值為參數,分析總結外週單側前庭功能減退患者的主觀視覺水平線特點,主觀視覺水平線、主觀視覺垂直線之間及其分彆與DP、UW值、病程的相關性.以SPSS 16.0軟件對數據進行統計學分析.結果 健康對照組主觀視覺水平線、主觀視覺垂直線的偏斜角度為-2,～2.以此為判定暘性與陰性的標準.外週單側前庭功能減退患者的主觀視覺水平線、主觀視覺垂直線暘性者分彆為46例(54.1%)、43例(50.6%),二者比較差異無統計學意義(χ2=12.5,P=0.481);DP暘性者55例(64.7%),與主觀視覺水平線、主觀視覺垂直線比較,差異均無統計學意義(χ2值分彆為0.19、2.86,JP值分彆為0.164、0.067).外週單側前庭功能減退患者的主觀視覺水平線與主觀視覺垂直線偏斜角度呈正相關(r=0.939,P<0.01),且二者與DP值均呈正相關(r值分彆為0.648、0.658,P值均<0.05),與UW值無相關性(r值分彆為0.048、0.085,P值均>0.05).根據主觀視覺水平線或主觀視覺垂直線、DP、UW3箇參數的暘性或陰性組閤,可分彆構成3種主要結果形式,即:主觀視覺水平線(+)DP(+)UW(+),主觀視覺水平線(-)DP(+)UW(+),主觀視覺水平線(-)DP(-)UW(+);主觀視覺垂直線(+)DP(+)UW(+),主觀視覺垂直線(-)DP(+)UW(+),主觀視覺垂直線(-)DP(-)UW(+).以上6種形式的病程中位數分彆為5.0、10.0、15.0 d,5.0、9.5、14.5 d,分彆行多樣本秩和檢驗,差異均有統計學意義(χ2水平線:8.80,P=0.012;χ2垂直線=6.26,P=0.040).結論 主觀視覺水平線可以評估耳石器(橢圓囊)功能.外週單側前庭功能減退患者的主觀視覺水平線、主觀視覺垂直線偏斜角度隨病程和前庭代償進程呈動態變化,可用于前庭靜態代償評定.
목적 탐토외주단측전정공능감퇴환자적주관시각수평선특점급기대전정공능평정적림상개치.방법 분별대85예외주단측전정공능감퇴환자급39명건강대조조인군행주관시각수평선、주관시각수직선급랭열시험등전정공능검측,이주관시각수평선급주관시각수직선편사각도、랭열시험우세편향(directional preponderance,DP)치、단측반규관경탄(unilateral weakness,UW)치위삼수,분석총결외주단측전정공능감퇴환자적주관시각수평선특점,주관시각수평선、주관시각수직선지간급기분별여DP、UW치、병정적상관성.이SPSS 16.0연건대수거진행통계학분석.결과 건강대조조주관시각수평선、주관시각수직선적편사각도위-2,～2.이차위판정양성여음성적표준.외주단측전정공능감퇴환자적주관시각수평선、주관시각수직선양성자분별위46례(54.1%)、43례(50.6%),이자비교차이무통계학의의(χ2=12.5,P=0.481);DP양성자55례(64.7%),여주관시각수평선、주관시각수직선비교,차이균무통계학의의(χ2치분별위0.19、2.86,JP치분별위0.164、0.067).외주단측전정공능감퇴환자적주관시각수평선여주관시각수직선편사각도정정상관(r=0.939,P<0.01),차이자여DP치균정정상관(r치분별위0.648、0.658,P치균<0.05),여UW치무상관성(r치분별위0.048、0.085,P치균>0.05).근거주관시각수평선혹주관시각수직선、DP、UW3개삼수적양성혹음성조합,가분별구성3충주요결과형식,즉:주관시각수평선(+)DP(+)UW(+),주관시각수평선(-)DP(+)UW(+),주관시각수평선(-)DP(-)UW(+);주관시각수직선(+)DP(+)UW(+),주관시각수직선(-)DP(+)UW(+),주관시각수직선(-)DP(-)UW(+).이상6충형식적병정중위수분별위5.0、10.0、15.0 d,5.0、9.5、14.5 d,분별행다양본질화검험,차이균유통계학의의(χ2수평선:8.80,P=0.012;χ2수직선=6.26,P=0.040).결론 주관시각수평선가이평고이석기(타원낭)공능.외주단측전정공능감퇴환자적주관시각수평선、주관시각수직선편사각도수병정화전정대상진정정동태변화,가용우전정정태대상평정.
Objective To analyze the characteristics of subjective visual horizontal ( SVH) and evaluate its clinical value for vestibular function in peripheral unilateral vestibular hypofunction ( UVH). Methods Eighty-five patients with UVH (study group) and 39 normal persons (control group) accepted vestibular function tests, including SVH, subjective visual vertical ( SVV ) and caloric test by video-nystagmography. The parameters of the angle of SVH and SVV, directional preponderance ( DP) and unilateral weakness(UW) of caloric test were observed. The correlation between SVH/SVV, DP, UW and the course of disease were investigated respectively. SPSS 16. 0 software was used to analyze the data. Results Reference range of SVH and SVV was from - 2° to 2° in the control group. Among the 85 patients, 46 cases(54. 1% ) and 43 cases(50. 6% ) had the abnormal values of SVH and SVV respectively, with no statistical significance( χ2 = 12. 5, P = 0. 481 ) by chi square test Fifty-five cases (64. 7% ) withabnormal DP had no statistical significance when compared with SVH and SVV respectively (χ2 values were 0. 19 and 2.86, respectively, P value were 0. 164, 0.067, respectively). In UVH, there were positive correlation between SVH, SVV and DP( r value was 0. 939, 0. 648, 0. 658, all P <0. 05) respectively, but no correlation between UW and SV H or SVV (r value was 0. 048, 0. 085, all P > 0. 05). According to the permutation and combination of the four parameters, positive or negative, three main groups could be defined [SVH(+)DP(+)UW( +), SVH( -)DP( +)UW( +), SVH( -)DP( -)UW( +); SVV( + ) DP ( +)UW( +), SVV( -)DP( +)UW( +), SVV( -)DP( -)UW( +)]. The course of disease in the three main groups was positively skewed distribution,with median of 5. 0, 10. 0, 15. 0 d and 5. 0, 9. 5, 14. 5 d respectively. By Kruskal-Wallis Test, χ2 value were 8. 80 and 6. 26, respectively( P value were 0.012, 0. 040, respectively), with statistical significance between the above three main groups. Conclusions The SVH value can evaluate the function of the otolithic. The angle of SVH and SVV are changing in the course of disease, SVH and SVV can be used as a guidance of the vestibular compensation evaluation.
