梅尼埃病的声导抗检查

Audiologic measure in Meniere′s disease

为了解口服脱水剂前后梅尼埃病耳的听力学变化情况，以期评价其诊断价值，对梅尼埃病３１例４８耳、其他眩晕病２０例４０耳、健康人２０例４０耳进行服甘油或尿素前后的纯音听阈、６７８Ｈｚ探测音峰静态声导纳（Ｙａ）及峰静态声导（Ｇａ）、共振频率及共振频率处的峰补偿静态声导纳（ΔＹ）及峰补偿静态声导（ΔＧ）、ＥＣｏｃｈＧ的－ＳＰ／ＡＰ比值及ＳＰ－ＡＰ（Ｎ１）波宽测定。结果发现，尿素组与甘油组的脱水试验异常率（阳性＋回跳）相近，统计学上无差异，故将两组结果合并计算。梅尼埃病组脱水试验的纯音听阈异常率为３２／４８（６６．６７％），６７８Ｈｚ探测音Ｇａ异常率为３０／４８（６２．５０％），共振频率处ΔＧ异常率为３３／４８（６８．７５％），－ＳＰ／ＡＰ比值的阳性率为２５／４８（５２．０８％），ＳＰ－ＡＰ（Ｎ１）波宽阳性率为３２／４８（６６．６７％）。χ２检验，各种阳性率之间差异无显著性。以纯音听阈脱水试验阳性耳数为基准，七项指标完全异常者为１７／３２耳，其诊断价值是相同的。服用甘油前后的共振频率处ΔＧ值及６７８Ｈｚ探测音的Ｇａ值的变化，可作为梅尼埃病的客观诊断的参考。

To determine some audiologic phenomena of Meniere′s disease before and after ingestion of dehydration agent and evaluate its diagnostic value, 48 ears of Meniere's disease, 40 ears of other vertigo disease and 40 normal ears were investigated. The measures were undertaken before and after glyceral or urea ingestion, which included threshold of pure tone audiometry, peak static acoustic admittance(Ya) and conductance(Ga) at probetone signal of 678 Hz, peak compensate static admittance(ΔY) and conductance(ΔG) at reasonace frequency, -SP/AP, and width of SP-N1 in ECochG. Results showed that abnormal rates of glyceral group and urea group were similar, and there was no significant statistical difference. So these two groups were combined together as one in statistics. The rate of totally abnormal ears were 17/32 in seven measures. Abnormal rates of dehydration test were: pure audiometry 66.67%, Ga 62.50%, -SP/AP 52.08%, width of SP-AP N1 66.67%. χ 2 test showed no significance statistical difference among these results. It indicated that these measures had same diagnostic value for the Meniere's disease. The shift value of G a and ΔG of dehydration test might be as the objective diagnostic methods of Meniere′s disease.