动态姿势图在外周性眩晕疾病中的临床应用

The clinical value of dynamic posturography in the peripheral vertigo

目的:探讨动态姿势图在外周性眩晕疾病中的诊断价值。方法:回顾性研究160例外周性眩晕患者资料。所有患者先行Synapsys(SPS)静动态平衡仪检查,然后运用视频眼震电图进行冷热试验。将结果进行比较分析。静态姿势图评定选取姿势图面积(SSKG)作为评定参数,动态姿势图评定选取感觉结构测试(SOT)结果作为评定参数。冷热试验选择一侧功能减低值进行评定。同时选取20例正常人,作动态姿势图检查作为对照。结果:外周性眩晕160例,动态姿势图SOT检查异常144例,占90.0%;冷热试验异常110例,占68.8%;静态姿势图SSKG异常76例,占47.5%。经统计学分析,动态姿势图异常检出率高于冷热试验及静态姿势图,差异有统计学意义(P<0.01)。20例正常对照的动态姿势图SOT检查结果仅1例(5.0%)异常,外周性眩晕患者动态姿势图异常率明显高于健康对照组。160例患者中,共有40例(25.0%)冷热试验结果正常者,动态姿势图检查可发现异常结果。结论:动态姿势图检查具有客观性和可靠性,对平衡功能的评价更全面,可检出冷热试验检查结果正常的外周性眩晕患者平衡系统的功能障碍。

Objective：To explore the clinical value of dynamic posturography in the diagnosis of peripheral vertigo. Method：One hundred and sixty peripheral vertigo patients with full clinical documents in vertigo clinic of our hospital from May 2007 to May 2008 were retrospectively analyzed in this study. All the patients firstly underwent the inspection of static and dynamic posturography and then were subjected to caloric test using videonystagmography. The results were conducted a comparative analysis. Surface of the statokinesigram （SSKG） was selected as assessment parameter of static posturography. The result of sensory organization test （SOT） were selected as assessment parameters of dynamic posturography. The unilateral weakness was selected as assessment parameter of caloric test. Twenty normal subjects were selected as control. Result：Among the 160 cases with peripheral vertigo, results of SOT in dynamic posturography were abnormal in 144 cases, with a sensitivity of 90.0% caloric test was abnormal in 110 cases, with a sensitivity of 68.8% ; static posturography was abnormal in 76 cases, with a sensitivity of 47.5 %. There existed a statistically significant difference between dynamic posturography and caloric test or static posturography. There were 40 patients（25.0%） who had normal caloric test results in which dynamic posturograph findings were abnormal. Among the 20 cases of normal people, results of SOT in dynamic posturography were abnormal in only one case（5.0 %）. Conclusion：With its superior sensitivity and specificity, dynamic posturography has been an objective and reliable approach in the diagnosis of peripheral vertigo. It can help to confirm the presence of abnormalities in some peripheral vertigo patients whose caloric results are normal.