Hunt综合征伴眩晕患者的半规管损伤频率特征

目的 探讨Hunt综合征伴眩晕患者的前庭半规管损伤频率特征以及视频头脉冲试验(video head impulse test,vHIT)在评估其前庭功能中的应用价值.方法 Hunt综合征伴眩晕患者26例(病例组)分别进行高频vHIT、中频摇头试验(head shaking test)和低频冷热试验(caloric test);30例健康人为对照组进行vHIT.以冷热试验单侧半规管反应非对称值(unilateral weakness,UW)、摇头试验诱发摇头眼震(head shaking nystagmus,HSN)、vHIT的增益值(video head impulse test gain,vHIT-G)为观察指标,应用SPSS 16.0统计软件分析对照组vHIT-G、病例组的三项试验结果特点及其相关性.结果 对照组6个半规管的vHIT-G均符合正态分布,方差分析,相互间差异无统计学意义(F=0.005,P＜0.01);双侧前、水平和后半规管平均vHIT-G((x)±s,下同)分别为16.80％±9.80％、16.57％±10.30％、16.52％±11.12％;病例组的患耳前、水平和后半规管vHIT-G分别为46.96％±34.54％、75.35％±35.29％、41.65％±32.87％,均符合正态分布,与对照组对应半规管比较差异有统计学意义(P值均＜0.01);vHIT、摇头试验和冷热试验阳性者分别为23例(88.46％)、22例(84.61％)和24例(92.31％),双侧确切概率法x2检验,P值均＞0.05,差异无统计学意义;UW与水平半规管vHIT-G之间存在正相关(r=0.692,P＜0.01).结论 Hunt综合征伴眩晕患者的半规管功能损伤呈多频或近乎全频性损伤,具有传导阻滞性神经损伤特点;vHIT可以作为Hunt综合征伴眩晕患者前庭功能评定的有效检查方法.

Frequency characteristics of the semicircular canals lesion in Hunt syndrome with vertigo

Objective To research the frequency characteristics of the semicircular canals lesion in Hunt syndrome with vertigo and the clinical value of the video head impulse test (vHIT) for vestibular function evaluated in this disease.Methods Thirty normal persons (control group) accepted the vHIT,26patients with Hunt syndrome with vertigo ( study group) accepted low,mid and high frequency vestibular function tests,including caloric test ( CT),head shaking test (HST) and vHIT.The parameters of the unilateral weakness (UW),head shaking nystagmus (HSN) and video head impulse test gain (vHIT-G)were observed.The correlations and characteristics of the results of the three tests in Hunt syndrome with vertigo deal were analyzed with SPSS 16.0 software.Results The vaules of vHIT-G of the six groups semicircular canal in the control group were normal distribution without statistical significance ( F =0.005,P ＜ 0.01 ),two sides anterior,horizontal and posterior semicircular canals vHIT-G average ( (x) ± s) were(16.80 ±9.80)％,(16.57 ± 10.30)％,(16.52 ± 11.12)％ respectively; in the study group the separately vHIT-G of the three canals of the affected side were (46.96 ± 34.54) ％,(75.35 ± 35.29 ) ％and (41.65 ± 32.87)％,in which statistical significance comparing with the control group was detected( all P ＜ 0.01 ); the positive one of the three tests vHIT,HSN and CT were 23 cases (88.46％),22 cases (84.61％)and 24 cases(92.31％ ),bilateral exact propability x2 test all the P ＞0.05;there were Positive correlation between UW and the vHIT-G of lateral semicircular canal (r =0.692,P ＜ 0.01 ).Conclusions The vestibular lesion of Hunt syndrome with vertigo is almost complete or multiple-frequency,which is characterized by the reduced or even aborted nerve conduction.Therefore,vHIT can be ultimately used for the screening test evaluating due to the vestibular function in Hunt syndrome with vertigo.