水平半规管扫视波的临床意义探究

doi:10.6040/j.issn.1673-3770.0.2024.441

摘要/Abstract

摘要： 目的通过比较视频头脉冲试验(video head impulse test, vHIT)与冷热试验(caloric test, CT)的结果,研究vHIT中水平半规管出现单纯扫视波(refixation saccades, RS)但不伴增益降低的临床价值,为临床精细化诊断评估提供参考。方法随机选取眩晕患者的3组数据:vHIT正常组为不伴扫视波且不伴增益降低(83例);vHIT单纯扫视组为伴扫视波、不伴增益降低(81例);vHIT异常组为伴扫视波,伴增益降低(54例),分别比较3组冷热试验异常率。另外在数据库中随机选取2组数据:冷热试验正常组为冷热试验正常(91例);冷热试验异常组为冷热试验异常(125例),分别比较vHIT单纯扫视发生率。结果 vHIT正常组、vHIT单纯扫视组、vHIT异常组的冷热试验异常率分别为28.92%、50.62%和94.44%,3组两两比较差异均有统计学意义(P=0.015,P<0.001,P<0.001)。冷热试验正常组和冷热试验异常组的vHIT单纯扫视发生率分别为34.07%和32.80%,差异无统计学意义(P=0.845)。结论临床上水平半规管vHIT测试出现扫视波,但不伴增益降低的结果,需补充冷热试验或其它前庭功能检查,以全面、精细化对患者的前庭功能进行综合评估。

关键词: 视频头脉冲试验, 扫视波, 冷热试验, 精细化诊断

Abstract: Objective By comparing the results of video Head Impulse Test(vHIT)and caloric test(CT), to study the clinical significance of refixation saccade(RS)waves in the horizontal semicircular canals and provide reference for clinical diagnosis. Methods Three groups of data were randomly selected from the database: normal vHIT, without RS without VOR gain reduction(83 cases); RS vHIT, with RS without VOR gain reduction(81 cases); abnormal vHIT, with RS with VOR gain reduction(54 cases). The abnormality rates of the three groups of the CT were compared respectively. In addition, two groups of data were randomly selected from the database, group A was normal CT(91 cases), group B was abnormal CT, a total of 125 cases; and the incidence of RS without VOR gain reduction in vHIT was compared respectively. Results The CT abnormality rates of normal vHIT, RS vHIT and abnormal vHIT were 28.92%, 50.62% and 94.44%, respectively, and the differences between the two comparisons of the three groups were statistically significant(P=0.015,P<0.001 and P<0.001). The incidence rates of vHIT RS without VOR gain reduction in group A and group B were 34.07% and 32.80% respectively, and the difference was not statistically significant(P=0.845). Conclusion The appearance of RS during the horizontal semicircular canals vHIT test, without VOR gain reduction, can serve as an important indication for supplementing the CT or other vestibular function assessments. This approach allows for a comprehensive and detailed evaluation of the patient's vestibular function.

Key words: Video head pulse test, Refixation saccades, Caloric Test, Refined diagnosis

中图分类号:

R739.62

马孝宝,沈佳丽,杨军,陈建勇,朱颂欢. 水平半规管扫视波的临床意义探究[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 40-45.

MA Xiaobao, SHEN Jiali, YANG Jun, CHEN Jianyong, ZHU Songhuan. Exploring the clinical implications of normal VOR gain with refixation saccades in lateral canal[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 40-45.

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