耳蜗电图诊断梅尼埃病的灵敏度研究

发布时间：2018-04-04 15:37

本文选题：耳蜗电图　切入点：梅尼埃病　出处：《临床耳鼻咽喉头颈外科杂志》2014年13期

【摘要】：目的:探讨耳蜗电图在梅尼埃病(MD)诊断中的应用价值。方法:将测试对象分为确诊、可能和疑似MD组,将可能和疑似MD组合并为可疑MD组。依据纯音听阈测试结果对确诊MD组患耳按听力损失程度进行病情分级。采用短声(click)和1 000、2 000、4 000Hz 3种频率tone burst(TB)分别对测试耳进行耳蜗电图测试,并计算和电位(SP)与听神经复合动作电位(AP)的振幅比值(SP/AP),同时采用由click刺激声引出的AP疏波和密波潜伏期的差值(AP shift)辅助诊断。分别计算不同刺激声不同测试方法的诊断阳性率,比较MD的诊断阳性率。结果:确诊MD组click SP/AP阳性率为41.2%,TB 1 000、2 000、4 000Hz阳性率分别为80.4%、72.5%、37.3%,AP shift阳性率为45.1%。配对χ2检验显示,TB 1 000 Hz与click SP/AP阳性率比较、TB 2 000Hz与click SP/AP阳性率比较均差异有统计学意义(均P0.01),其中TB 1 000Hz诊断阳性率最高,即灵敏度最高。确诊MD组与可疑MD组患耳click SP/AP阳性率分别为41.2%和12.0%(P0.05),AP shift阳性率分别为45.1%和8.0%(P0.01),χ2检验显示2组间click SP/AP和AP shift阳性率差异有统计学意义。结论:耳蜗电图在MD诊断及鉴别诊断中作用显著,特别是采用1 000Hz和2 000HzTB刺激声,其诊断灵敏度高达80.4%和72.5%。AP shift也被证明是一种有效的测量方法,在辅助诊断MD中作用显著。
[Abstract]:Objective: to evaluate the value of electrocochocardiography in the diagnosis of Meniere's disease.Methods: the test subjects were divided into confirmed, probable and suspected MD groups.According to the results of pure tone audiometry, the patients in MD group were classified according to the degree of hearing loss.Three frequencies of tone burster-TBwere used to test the test ears with click-click and 1 000 000Hz, respectively, and the electrocochocardiography of the tested ears was carried out by electrocochlear electrogram (ECoG).The amplitude ratio of SPP to APP was calculated, and the difference of the latency of AP sparse wave and dense wave induced by click stimulation was used to assist the diagnosis.The positive rate of diagnosis was calculated and compared with that of MD.Results: in MD group, the positive rate of click SP/AP was 41.2 TB1 000 and 4 000Hz positive rate was 80.4% and 72.5% respectively. The positive rate of AP shift was 45.1%.Paired 蠂 2 test showed that the positive rates of TB1 000 Hz and click SP/AP were significantly higher than that of TB2 000Hz and click SP/AP (all P 0.01). The diagnostic positive rate of TB1 000Hz was the highest, that is, the sensitivity was the highest.The positive rates of click SP/AP were 41.2% and 12.0% respectively in confirmed MD group and suspected MD group. The positive rates of click SP/AP and AP shift were 45.1% and 8.0%, respectively. 蠂 2 test showed that there were significant differences in click SP/AP and AP shift between the two groups.Conclusion: Ecochocardiography plays an important role in the diagnosis and differential diagnosis of MD, especially with 1 000Hz and 2 000HzTB stimulation sound. The diagnostic sensitivity of ECoG is 80.4% and 72.5%.AP shift is proved to be an effective method in the diagnosis of MD.
【作者单位】：华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科;京山县人民医院耳鼻咽喉科;
【分类号】：R764.33

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