前庭诱发性肌源性电位及前庭冷热试验在不同分期梅尼埃病中的应用
发布时间：2018-08-06 20:35
【摘要】：目的:探索前庭诱发性肌源性电位(vestibular evoked myogenic potential,VEMP)及前庭冷热试验(caloric test)在梅尼埃病(Meniere disease,MD)不同听力分期中的特征及临床意义。材料与方法:对2015年7月至2016年5月期间就诊于安徽省立医院耳鼻咽喉科的梅尼埃病患者共60例,按梅尼埃病听力分期标准分为1期9例,2期10例,3期26例,4期15例,行颈肌前庭诱发性肌源性电位(cervical vestibular evoked myogenic potential,c VEMP)、眼肌前庭诱发性肌源性电位(ocular vestibular evoked myogenic potential,o VEMP)及前庭冷热试验检查,另纳入正常参照组33人,建立VEMP实验室正常范围。结果:c VEMP在梅尼埃病患者1、2、3、4期中异常率分别为11.11%、40.00%、26.92%、33.33%,而o VEMP在各分期异常率分别为77.78%、70.00%、76.92%、80.00%,二者异常检出率均呈总体上升趋势,且在不同听力分期组中及与正常参照组对比均有统计学意义(P0.05)。在可引出VEMP的梅尼埃病患者中,患侧c VEMP在1,2,3,4不同听力分期组振幅分别为78.05±28.99μV,87.60±25.98μV,76.54±28.56μV,62.59±31.62μV,o VEMP不同听力分期组振幅分别为4.28±3.99μV,3.50±2.33μV,2.46±2.16μV,1.31±0.49μV,c VEMP及o VEMP振幅均呈总体下降趋势。梅尼埃病患者前庭冷热试验异常检出率随梅尼埃病分期的增加上升显著,在4期患者中高达86.67%。结论:梅尼埃病患者c VEMP、o VEMP及前庭冷热试验检查异常检出率均随分期增加而呈总体上升趋势,患侧VEMP检出电位振幅随分期增加呈下降趋势,提示梅尼埃病患者耳石器及水平半规管功能受损与病情程度正相关。在梅尼埃病患者VEMP检查中,o VEMP对梅尼埃病各分期的检出率均明显高于c VEMP,对梅尼埃病患者的诊断更为高效。晚期梅尼埃病患者的前庭冷热检查异常检出率明显升高,而o VEMP更加适用于轻度听力受损患者的诊断。c VEMP及o VEMP结合前庭冷热试验可共同评估梅尼埃病患者耳石器及水平半规管功能,并对进一步诊疗作出指导。
[Abstract]:Objective: to explore the characteristics and clinical significance of vestibular evoked myogenic potential (vestibular evoked myogenic potentialis-VEMP) and vestibular cold and hot test (caloric test) in different hearing stages of Meniere disease (MD). Materials and methods: from July 2015 to May 2016, 60 patients with Meniere's disease were admitted to the Department of Otorhinolaryngology, Anhui Provincial Hospital. According to the hearing staging criteria of Meniere's disease, they were divided into 9 cases of stage 1, 10 cases of stage 2 and 26 cases of stage 3 and 15 cases of stage 4. Cervical vestibular evoked myogenic potential (cervical vestibular evoked myogenic potentialc VEMP),) and vestibular evoked myogenic potential VEMP (ocular vestibular evoked myogenic potentialo VEMP) and vestibular cold and thermal tests were performed in 33 patients in the normal control group. The normal range of VEMP laboratory was established. Results in Meniere's disease patients, the abnormal rates of VEMP were 11.11 and 26.92%, respectively, while the abnormal rates of o VEMP in all stages were 77.78 and 76.92%, respectively. The detection rate of the two abnormalities showed an overall upward trend. And in different hearing stages group and normal reference group compared with statistical significance (P0.05). In Meniere's disease patients with VEMP, the amplitudes of c VEMP in different hearing staging groups were 78.05 卤28.99 渭 V, 87.60 卤25.98 渭 V, 76.54 卤28.56 渭 V, 62.59 卤31.62 渭 V, the amplitudes of c VEMP were 4.28 卤3.99 渭 V, 3.50 卤2.33 渭 V, 2.46 卤2.16 渭 V, 1.31 卤0.49 渭 V VEMP and o VEMP, respectively. The abnormal detection rate of vestibular cold and hot test in patients with Meniere's disease increased significantly with the increase of Meniere's disease stage, and reached 86.67 in stage 4 patients. Conclusion: the abnormal detection rate of c VEMPO VEMP and vestibular cold and thermal test in patients with Meniere's disease showed an overall upward trend with the increase of stage, and the amplitude of VEMP detection potential in the affected side showed a decreasing trend with the increase of stages. The results suggest that the impairment of otolithiasis and horizontal semicircular canal function in patients with Meniere's disease is positively correlated with the severity of the disease. In the VEMP examination of Meniere's disease, the detection rate of VEMP in all stages of Meniere's disease was significantly higher than that of c-VEMP.The diagnosis of Meniere's disease was more effective. The detection rate of abnormal vestibular cold and thermal examination in patients with advanced Meniere's disease was significantly higher than that in patients with advanced Meniere's disease. However, o VEMP is more suitable for the diagnosis of mild hearing impairment patients. C VEMP and o VEMP combined with vestibular cold and hot test can evaluate the otolithiasis and horizontal semicircular canal function in patients with Meniere's disease, and provide guidance for further diagnosis and treatment.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.33
本文编号：2168916
[Abstract]:Objective: to explore the characteristics and clinical significance of vestibular evoked myogenic potential (vestibular evoked myogenic potentialis-VEMP) and vestibular cold and hot test (caloric test) in different hearing stages of Meniere disease (MD). Materials and methods: from July 2015 to May 2016, 60 patients with Meniere's disease were admitted to the Department of Otorhinolaryngology, Anhui Provincial Hospital. According to the hearing staging criteria of Meniere's disease, they were divided into 9 cases of stage 1, 10 cases of stage 2 and 26 cases of stage 3 and 15 cases of stage 4. Cervical vestibular evoked myogenic potential (cervical vestibular evoked myogenic potentialc VEMP),) and vestibular evoked myogenic potential VEMP (ocular vestibular evoked myogenic potentialo VEMP) and vestibular cold and thermal tests were performed in 33 patients in the normal control group. The normal range of VEMP laboratory was established. Results in Meniere's disease patients, the abnormal rates of VEMP were 11.11 and 26.92%, respectively, while the abnormal rates of o VEMP in all stages were 77.78 and 76.92%, respectively. The detection rate of the two abnormalities showed an overall upward trend. And in different hearing stages group and normal reference group compared with statistical significance (P0.05). In Meniere's disease patients with VEMP, the amplitudes of c VEMP in different hearing staging groups were 78.05 卤28.99 渭 V, 87.60 卤25.98 渭 V, 76.54 卤28.56 渭 V, 62.59 卤31.62 渭 V, the amplitudes of c VEMP were 4.28 卤3.99 渭 V, 3.50 卤2.33 渭 V, 2.46 卤2.16 渭 V, 1.31 卤0.49 渭 V VEMP and o VEMP, respectively. The abnormal detection rate of vestibular cold and hot test in patients with Meniere's disease increased significantly with the increase of Meniere's disease stage, and reached 86.67 in stage 4 patients. Conclusion: the abnormal detection rate of c VEMPO VEMP and vestibular cold and thermal test in patients with Meniere's disease showed an overall upward trend with the increase of stage, and the amplitude of VEMP detection potential in the affected side showed a decreasing trend with the increase of stages. The results suggest that the impairment of otolithiasis and horizontal semicircular canal function in patients with Meniere's disease is positively correlated with the severity of the disease. In the VEMP examination of Meniere's disease, the detection rate of VEMP in all stages of Meniere's disease was significantly higher than that of c-VEMP.The diagnosis of Meniere's disease was more effective. The detection rate of abnormal vestibular cold and thermal examination in patients with advanced Meniere's disease was significantly higher than that in patients with advanced Meniere's disease. However, o VEMP is more suitable for the diagnosis of mild hearing impairment patients. C VEMP and o VEMP combined with vestibular cold and hot test can evaluate the otolithiasis and horizontal semicircular canal function in patients with Meniere's disease, and provide guidance for further diagnosis and treatment.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.33
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