【摘要】：目的:通過前庭自旋轉(zhuǎn)試驗(yàn)(VAT)分析前庭性偏頭痛(VM)患者的前庭眼反射特征,探討VAT技術(shù)在前庭性偏頭痛輔助診斷中的臨床應(yīng)用價值。方法:分別對臨床確診的VM患者69例、后循環(huán)缺血(PCI)性眩暈患者73例、正常人65例在完成臨床檢查的基礎(chǔ)上行VAT測試,以VAT增益、相位及非對稱性為指標(biāo),分析比較其前庭眼反射特征。結(jié)果:(1)69例VM患者中水平或垂直增益異常為54例(78.3%);水平或/和垂直相位延遲66例(95.7%);非對稱性異常13例(異常率為18.8%)。(2)54例增益異常的VM患者中,46例(66.7%)為高增益,42例表現(xiàn)為高增益伴高相位,36例表現(xiàn)為單純水平高增益(且主要集中在2~4 Hz異常,26例);8例(11.6%)表現(xiàn)為低增益。(3)PCI組VAT特征:73例PCI患者中,47例(64.4%)為高增益,11例(15.1%)表現(xiàn)為低增益,主要呈高增益。PCI組與VM組比較,高增益、低增益差異均無統(tǒng)計學(xué)意義(χ~2=0.07、0.37,P0.05)。VM組與PCI組的VAT均以高增益為主,差異無統(tǒng)計學(xué)意義;在相位延遲及非對稱指標(biāo)中差異有統(tǒng)計學(xué)意義。(4)正常人組VAT特征:四項(xiàng)指標(biāo)異常陽性率較低。正常人組與VM組比較,高增益及相位延遲差異均有統(tǒng)計學(xué)意義(χ~2=56.17、97.57,P0.01),低增益非及對稱性比較差異無統(tǒng)計學(xué)意義。結(jié)論:VM的前庭眼反射以高增益為主,多呈現(xiàn)在2~4Hz頻率段,且多伴有相位延遲。VM主要累及前庭中樞,VAT檢測可為VM診斷提供參考。
[Abstract]:Objective: to analyze the vestibular eye reflex characteristics in patients with vestibular migraine (VM) by vestibular autorotation test (VAT) and to explore the clinical value of VAT technique in the auxiliary diagnosis of vestibular migraine. Methods: 69 cases of VM, 73 cases of posterior circulation ischemic (PCI) vertigo and 65 cases of normal controls were tested with VAT on the basis of clinical examination. VAT gain, phase and asymmetry were used as indexes. The characteristics of vestibular eye reflex were analyzed and compared. Results: (1) in 69 patients with VM, 54 cases (78.3%) had abnormal horizontal or vertical gain, 66 cases (95.7%) had horizontal or / and vertical phase delay. Among the 54 VM patients with abnormal gain, 46 cases (66.7%) had high gain and 42 cases had high gain with high phase. 36 cases showed simple horizontal high gain (26 cases were mainly abnormal in 2o 4 Hz). (3) among 73 patients with PCI, 47 (64.4%) had high gain and 11 (15.1%) had low gain. (3) the characteristics of VAT were high gain in PCI group and VM group in PCI group. There was no significant difference between high gain and low gain (蠂 ~ 2 0.07 0.37% P0.05). The VAT of). VM group and PCI group were mainly high gain, but the difference was not statistically significant. There were significant differences in phase delay and asymmetric indexes. (4) VAT characteristics of normal subjects: the positive rate of abnormal four indexes was lower. The difference of high gain and phase delay between normal group and VM group was statistically significant (蠂 ~ 2 ~ 2 / 56.17 ~ 97.57 / P0.01), but there was no significant difference in low gain asymmetry and symmetry. Conclusion: the vestibular eye reflex of VM is dominated by high gain, most of them are present in the frequency of 2~4Hz, and most of them are accompanied by phase delay. VM mainly involves the vestibular center, and the detection of VAT can provide a reference for the diagnosis of VM.
【作者單位】： 天津市第一中心醫(yī)院耳鼻咽喉頭頸外科天津市耳鼻喉科研究所;
【基金】：“十二五”國家科技支撐計劃項(xiàng)目(No:2012BAI12B02) 天津市衛(wèi)計委科技攻關(guān)項(xiàng)目(No:10KG219)
【分類號】：R747.2

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