几项耳功能检查在梅尼埃病诊断中的意义

目的：探讨前庭功能检查[前庭双温试验和前庭诱发肌源性电位（VEMP）检查]及耳蜗电图在梅尼埃病诊治中的意义。方法：梅尼埃病患者行纯音测听、听性脑干反应测听、前庭双温试验（冷热气或冷热水）、VEMP检查和耳蜗电图检查（单侧或双侧耳蜗电图检查）。结果：①前庭双温试验：病程0～5年，冷热试验CP值异常的百分率为56．9％；6～10年为75．9％；11年以上为50．0％。前庭双温试验的总阳性率为61．6％。冷热试验CP值与病程短相关（P〈0．05）。②VEMP：病程0～5年，VEMP异常的百分率为57．4％；6～10年为60．0％；11年以上组为57．1％。VEMP的总阳性率为58．0％。VEMP正常和异常的患者病程差异无统计学意义（P〉0．05）。③耳蜗电图：病程0～5年，-SP／AP异常的百分率为72．1％；6～10年为73．3％；〉11年为81．3％。总阳性率为73．7％。-SP／AP正常和一SP／AP异常的患者病程差异无统计学意义（P〉0．05）。结论：梅尼埃病的诊断仍以临床症状为基础，结合耳蜗电图、前庭双温试验和VEMP检查，可达到早期诊断、提高确诊率的目的。

Significance of some otologic function tests in dignosis of Meniere's disease

OBJECTIVE: To investigate the significance of vestibular function battery and electrocochleogram on diagnosis of Menieres disease. METHOD: Patients with Meniere's diasese were given pure tone hearing threshold test, auditory brainsten posponse (ABR), electrocochleogram (ECoG), vestibular bithermal caloric test and vestibular evoked myogenic potentials (VEMP) test. RESULT: (1) As for the bithermal caloric test, the percentage of the abnormal canal paresis (CP) at three durations, i.e. , 0 to approximately 5 years, 6 to approximately 10 years and over 11 years were 56.9%, 75.9% and 61.6% respectively. The total positive rate was 50.0%. CP and duration of Meniere's disease had low correlation (P < 0.05). (2) The percentage of the abnormal VEMP at three durations, i.e., 0-5 years,6-10 years and over 11 years were 57.4%, 60% and 57.1% respectively. The total positive rate was 58.0%. The duration of Meniere 's disease with normal and abnormal VEMP had no significant difference( P >0.05). (3) The percentage of the abnormal ECoG at three durations, i.e., 0-5 years, 6-10 years and over 11 years were 72.1%, 73.3% and 81.3% (49/68,22/30 and 13/16) respectively. The total positive rate was 76.9%. The duration of Meniere's disease with normal and abnormal ECoG had no significant difference (P >0.05). CONCLUSION: Diagnosis of Meniere's disease is mainly based on the medical history. If it could combine with ECoG, bithermal caloric test and VEMP, the diagnosis would be earlier and more accurate.