CAJ | 학술논문

目的探讨水平半规管良性阵发性位置性眩晕(BPPV)眼震的方向、强度、时间等参数的客观特征及机制.方法水平半规管BPPV患者233例,其中水平半规管管石症(horizontal semicircular canalithasis,HSC-Can) 179例,水平半规管壶腹嵴顶结石症(horizontal semicircular canal cupulolithiasis,HSC-Cup)54例.应用视频眼震图仪分别记录滚转试验诱发眼震,比较各个试验头位的眼震方向、强度、时间等参数特点.采用SPSS17.0统计软件进行数据处理.结果水平半规管BPPV患者滚转试验在左侧、右侧转头位均可诱发出水平性眼震.HSC-Can诱发眼震方向与转头方向相同,向患侧和健侧转头位诱发眼震的潜伏期(-x±s,下同)为(1.922±1.501)s和(1.447±0.855)s,持续时间为(25.620±10.409)s和(22.110±10.931)s,强度为(56.441±33.168)°/s和(24.239±13.892)°/s,向患侧转头诱发眼震的潜伏期、持续时间及强度均大于健侧,差异均具有统计学意义(t值分别为3.715、15.219和4.070,P值均＜0.01),其中眼震强度之比约为2∶1.HSC-Cup诱发眼震方向与转头方向相反,向健侧转头诱发眼震的强度明显大于向患侧转头,其强度之比约为2∶1,差异具有统计学意义(t=-7.634,P＜0.01)；而向健侧和向患侧转头诱发眼震的潜伏期,差异则无统计学意义(t=1.670,P=0.101).HSC-Can滚转试验中向患侧转头诱发眼震的潜伏期、强度均大于HSC-Cup向健侧转头,但差异无统计学意义(t值分别为1.554和0.305,P值均＞0.05).结论水平半规管BPPV患者滚转试验向左右侧转头诱发眼震的强度均遵循Ewald定律,强弱之比约为2∶1；潜伏期、持续时间及强度等眼震图参数可作为BPPV的客观诊断指标.
목적 탐토수평반규관량성진발성위치성현훈(BPPV)안진적방향、강도、시간등삼수적객관특정급궤제.방법 수평반규관BPPV환자233례,기중수평반규관관석증(horizontal semicircular canalithasis,HSC-Can) 179례,수평반규관호복척정결석증(horizontal semicircular canal cupulolithiasis,HSC-Cup)54례.응용시빈안진도의분별기록곤전시험유발안진,비교각개시험두위적안진방향、강도、시간등삼수특점.채용SPSS17.0통계연건진행수거처리.결과 수평반규관BPPV환자곤전시험재좌측、우측전두위균가유발출수평성안진.HSC-Can유발안진방향여전두방향상동,향환측화건측전두위유발안진적잠복기(-x±s,하동)위(1.922±1.501)s화(1.447±0.855)s,지속시간위(25.620±10.409)s화(22.110±10.931)s,강도위(56.441±33.168)°/s화(24.239±13.892)°/s,향환측전두유발안진적잠복기、지속시간급강도균대우건측,차이균구유통계학의의(t치분별위3.715、15.219화4.070,P치균＜0.01),기중안진강도지비약위2∶1.HSC-Cup유발안진방향여전두방향상반,향건측전두유발안진적강도명현대우향환측전두,기강도지비약위2∶1,차이구유통계학의의(t=-7.634,P＜0.01)；이향건측화향환측전두유발안진적잠복기,차이칙무통계학의의(t=1.670,P=0.101).HSC-Can곤전시험중향환측전두유발안진적잠복기、강도균대우HSC-Cup향건측전두,단차이무통계학의의(t치분별위1.554화0.305,P치균＞0.05).결론 수평반규관BPPV환자곤전시험향좌우측전두유발안진적강도균준순Ewald정률,강약지비약위2∶1；잠복기、지속시간급강도등안진도삼수가작위BPPV적객관진단지표.
Objective To discuss the objective characteristics and mechanism of nystagmus direction,intensity and time in horizontal semicircular canal benign paroxysmal positional vertigo (HSCBPPV).Methods A total of 233 patients with HSC-BPPV,whereas 179 horizontal semicircular canalithasis (HSC-Can) and 54 horizontal semicircular cupulolithiasis (HSC-Cup) were involved respectively.The induced nystagmus in roll tests recorded by video-nystagmograph(VNG),whose direction,intensity and time characteristics were compared in various BPPV.Results Horizontal nystagmus was both induced by turning left or right in HSC-BPPV roll tests.The direction of the induced nystagmus was the same with turning in HSC-Can.The latency,duration time and intensity (x ± s) turning to lesion and normal side were (1.922± 1.501)s and (1.447±0.855)s,(25.620 ± 10.409)s,and (22.110± 10.931)s,(56.441 ± 33.168)°/s and (24.239 ± 13.892)°/s in HSC-Can.The latency,duration time and intensity turning to lesion side were larger than normal side(t =3.715,15.219 and 4.070,P ＜ 0.01),the difference was statistically significant,and the intensity rate was about 2∶ 1.The direction of the induced nystagmus was opposite to turning in HSC-Cup.The intensity turning to normal side was larger than lesion side obviously.The intensity rate was about 2∶ 1,the difference was statistically significant(t =-7.634,P ＜ 0.01).While the latency and intensity of turning to lesion side in HSC-Can were larger than turn to normal side in HSCCup,and the difference detected no statistically significant difference (t =1.554 and 0.305,P ＞ 0.05).Conclusions The induced nystagmus intensity of head to two sides in roll tests for HSC-BPPV both follow Ewald's law,and the ratio between stronger and weaker are both 2∶ 1.These nystagmus parameters of VNG in roll tests are an objective guideline for BPPV diagnosis.