突聋伴眩晕患者前庭诱发肌源性电位的临床研究

发布时间：2019-05-01 06:05

【摘要】：目的通过观察突发性聋伴眩晕患者前庭诱发肌源性电位的引出率及各参数,探讨前庭诱发肌源性电位对突聋伴眩晕患者内耳损伤情况的诊断及预后评估。方法收集50例单耳突聋伴眩晕的患者,50例单耳突聋不伴眩晕患者及60例正常听力人作为对照组,分析对比o VEMP及c VEMP的引出率和各参数变化。结果引出率:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组o VEMP引出率分别为24%、42%、48%、100%,c VEMP引出率分别为:56%、74%、64%、100%,病例组患耳和对侧耳相比,o VEMP及c VEMP引出率差异无统计学意义(P0.05),病例组患耳及对侧耳分别和正常对照组比较,o VEMP及c VEMP引出率均明显降低(P0.05),病例组患耳o VEMP引出率明显低于突聋不伴眩晕组(P0.05)。o VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数(N1潜伏期、P1潜伏期、P1-N1振幅)两两比较,组间不对称比(AR)比较,差异均无统计学意义(P均0.05)。c VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数比较,患耳及对侧耳P1-N1振幅比突聋不伴眩晕组及正常对照组均明显降低(P0.05),病例组AR比正常对照组明显增高(P0.05),o VEMP及c VEMP结果与听力损失分型、听力损失程度分级无明显相关性(P0.05),但与疗效分级明显相关(P0.05)。结论突聋伴眩晕患者存在同侧及对侧的椭圆囊(前庭上神经)和球囊(前庭下神经)传导功能障碍,前庭诱发肌源性电位为突聋伴眩晕患者耳石器及前庭神经功能评估提供客观依据。
[Abstract]:Objective to observe the evoked rate and parameters of vestibular evoked myogenic potentials in patients with sudden deafness with vertigo, and to explore the diagnosis and prognosis of vestibular evoked myogenic potentials in patients with sudden deafness with vertigo. Methods 50 patients with mono-auricular deafness with vertigo, 50 patients with simple aural deafness without vertigo and 60 normal hearing subjects were collected as the control group. The induced rates and parameters of o-VEMP and c-VEMP were analyzed and compared. Results the induced rate of VEMP was 24%, 42%, 48%, 100% in case group, contralateral ear, sudden deafness without vertigo and normal control group, respectively. The induced rate of c-VEMP was 56%, 74%, 64%, 100%, respectively. There was no significant difference in the induced rate of, o VEMP and c-VEMP between the case group and the contralateral ear (P0.05). The incidence rate of, o VEMP and c-VEMP in the case group and the contralateral ear was significantly lower than that in the normal control group (P0.05). The induced rate of o-VEMP in the case group was significantly lower than that in the sudden deafness without vertigo group (P0.05) (P05 -). O VEMP: case group, contralateral ear, sudden deafness without vertigo group and normal control group) (N1 latency, P1 latency, P _ 1 latency). There was no significant difference in P1-N1 amplitude between the two groups, and there was no significant difference in the asymmetrical ratio between the two groups (P0.05). C VEMP: group, the contralateral ear, the deafness without vertigo group and the normal control group). The amplitude of P1-N1 in the affected ears and contralateral ears was significantly lower than that in the deafness without vertigo group and the normal control group (P0.05), and the AR in the patient group was significantly higher than that in the normal control group (P0.05), o VEMP and c VEMP results and hearing loss classification). There was no significant correlation between the grade of hearing loss (P0.05), but it was significantly correlated with the grade of therapeutic effect (P0.05). Conclusion there are ipsilateral and contralateral ellipsoidal (superior vestibular nerve) and balloon (inferior vestibular nerve) conduction dysfunction in patients with synaptic deafness with vertigo. Vestibular evoked myogenic potential provides objective basis for evaluation of otolith and vestibular nerve function in patients with sudden deafness with vertigo.
【作者单位】：唐山市协和医院耳鼻咽喉头颈外科;华北理工大学附属医院血管外科;河北医科大学第二医院耳鼻咽喉科;
【基金】：2017年度河北省医学科学研究重点课题计划,项目编号:20171308~~
【分类号】：R764

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