前庭性偏头痛和梅尼埃病患者变温试验结果的比较

发布时间：2018-03-17 04:16

  本文选题：前庭性偏头痛　切入点：梅尼埃病　出处：《临床耳鼻咽喉头颈外科杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的:分析前庭性偏头痛(VM)和梅尼埃病(MD)患者的变温试验特点,为鉴别2组疾病提供客观依据。方法:采用病例对照研究方法。入选左耳受损、听力受损程度分级为轻、中度MD病例(11例),VM病例(18例)与MD组相匹配,所有患者均进行变温试验检查。比较2组水平、垂直眼震的最大慢相角速度(SPVmax),根据水平和垂直SPVmax分别计算水平半规管轻瘫(CP)、垂直半规管CP;以SPVmax为5°/s作为分界点,分别判断单侧(UW-VR)、双侧前庭反应减弱(BW-VR)和单侧(UVR)、双侧垂直反应(BVR)阳性及双侧垂直反应阴性(NBVR);根据垂直SPVmax计算左、右耳垂直总反应(LV、RV)及耳间差异(IED-VR)。结果:2组患者各项水平SPVmax比较,除左侧冷试验(LC)外,其他VM组均较MD组大(P0.05);其中右侧热试验(RW)2组均反应最大,而VM组(34.5±17.27)显著大于MD组(12.82±6.69,P0.01)。各项垂直SPVmax仅RW时2组有差异(P0.01),其他均差异无统计学意义;其中VM组以RW(6.00±4.45)、MD组以LC(1.27±2.00)最大,2组差异有统计学意义(P0.01)。水平CP≥25%所占比例VM组(72.22%)和MD组(54.55%)差异无统计学意义,但UW-VR、BW-VR所占比例VM组(5.56%、0)较MD组(27.27%、18.18%)明显减少(P0.05)。VM组和MD组的垂直CP≥25%差异有统计学意义(94.44%、27.27%,P0.01),其中VM组UVR(左5.56%、右77.78%)、BVR(0)阳性、BVW(16.67%),MD组UVR(左9.09%、右0)、BVR(0)阳性、BVW(90.91%),2组比较均差异有统计学意义(均P0.01);VM组双耳间垂直总反应差异有统计学意义(P0.01,LVRV),而MD组差异无统计学意义,其中VM组的IED-VR(左侧明显16.67%,右侧明显83.33%)和MD组(左侧明显36.36%,右侧明显9.09%,两侧无差别54.55%)比较差异有统计学意义(P0.01)。结论:变温试验时VM患者比MD患者前庭反应更敏感,更易诱发垂直反应,可较好鉴别VM和MD。
[Abstract]:Objective: to analyze the characteristics of temperature change test in patients with vestibular migraine (VM) and Meniere's disease (MDD) in order to provide an objective basis for differentiating two groups of diseases. 11 cases with moderate MD and 18 cases with VM) were matched with MD group. All patients were examined by temperature change test. The maximum slow phase angular velocity of perpendicular nystagmus was calculated according to horizontal and vertical SPVmax. The horizontal semicircular canal paresis and vertical semicircular canal CPS were calculated with SPVmax of 5 掳/ s as the dividing point. UW-VRV, bilateral vestibular reaction weakened BW-VRV, unilateral UVRR, bilateral vertical-reaction BVRR) positive and bilateral vertical-reaction negative NBVRV were determined respectively, the vertical total response of left and right ears were calculated according to vertical SPVmax, and the difference of IED-VRV between the two groups was obtained. Results the SPVmax levels of the two groups were compared. With the exception of left cold test (LCL), all the other VM groups were higher than MD group (P 0.05), and the right side heat test group (RW2) had the largest response, while the VM group (34.5 卤17.27) was significantly higher than MD group (12.82 卤6.69 渭 g / L). There was no significant difference in all vertical SPVmax between the two groups when RW was the only time, and no significant difference was found in the other two groups. There was no significant difference between VM group (RW(6.00 卤4.45) and MD group (LC(1.27 卤2.00). There was no significant difference between VM group (P > 25%) and MD group (n = 54.55). But the proportion of UW-VRV BW-VR in VM group (5.56%) was significantly lower than that in MD group (27.27 卤18.18). There was a significant difference in the vertical CP 鈮，

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