前庭性偏头痛患者的前庭眼反射特征分析

发布时间：2018-12-09 21:46

【摘要】：目的:通过前庭自旋转试验(VAT)分析前庭性偏头痛(VM)患者的前庭眼反射特征,探讨VAT技术在前庭性偏头痛辅助诊断中的临床应用价值。方法:分别对临床确诊的VM患者69例、后循环缺血(PCI)性眩晕患者73例、正常人65例在完成临床检查的基础上行VAT测试,以VAT增益、相位及非对称性为指标,分析比较其前庭眼反射特征。结果:(1)69例VM患者中水平或垂直增益异常为54例(78.3%);水平或/和垂直相位延迟66例(95.7%);非对称性异常13例(异常率为18.8%)。(2)54例增益异常的VM患者中,46例(66.7%)为高增益,42例表现为高增益伴高相位,36例表现为单纯水平高增益(且主要集中在2~4 Hz异常,26例);8例(11.6%)表现为低增益。(3)PCI组VAT特征:73例PCI患者中,47例(64.4%)为高增益,11例(15.1%)表现为低增益,主要呈高增益。PCI组与VM组比较,高增益、低增益差异均无统计学意义(χ~2=0.07、0.37,P0.05)。VM组与PCI组的VAT均以高增益为主,差异无统计学意义;在相位延迟及非对称指标中差异有统计学意义。(4)正常人组VAT特征:四项指标异常阳性率较低。正常人组与VM组比较,高增益及相位延迟差异均有统计学意义(χ~2=56.17、97.57,P0.01),低增益非及对称性比较差异无统计学意义。结论:VM的前庭眼反射以高增益为主,多呈现在2~4Hz频率段,且多伴有相位延迟。VM主要累及前庭中枢,VAT检测可为VM诊断提供参考。
[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.
【作者单位】：天津市第一中心医院耳鼻咽喉头颈外科天津市耳鼻喉科研究所;
【基金】：“十二五”国家科技支撑计划项目(No:2012BAI12B02) 天津市卫计委科技攻关项目(No:10KG219)
【分类号】：R747.2

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