单侧前庭周围性眩晕的平稳跟踪实验结果分析

The analysis of smooth pursuit test in unilateral vestibular peripheral vertigo

目的:对单侧前庭周围性眩晕的眼震图平稳跟踪实验(SPT)结果进行定性、定量分析并探讨其影响因素。方法:应用法国Synapsys视频眼震图仪对185例单侧前庭周围性眩晕患者(实验组)和51例正常人(对照组)行SPT和自发性眼震(SN)检测,以SPT水平眼跟踪波的增益值及SN为评定参数,对SPT眼动波形及增益进行定性、定量分析,并分析SPT眼动增益与SN强度之间的相关性。结果:实验组SPT呈现为Ⅰ、Ⅱ、Ⅲ型波,分别为105例(56.8%)、72例(38.9%)、8例(4.3%),存在SN者58例(31.4%),无Ⅳ型波。对照组仅呈现Ⅰ、Ⅱ型波,分别为38例(74.5%)、13例(25.5%),无Ⅲ、Ⅳ型波及SN。量化分析:对照组、实验组总体及定性划分后各型波的强、弱侧增益之间进行t检验,均差异有统计学意义(P<0.05);2组Ⅰ、Ⅱ型波的弱侧增益值之间均差异有统计学意义,强侧增益值之间均差异无统计学意义。对照组总体及定性划分后Ⅰ、Ⅱ波的左右侧增益值均差异无统计学意义(均P>0.05),强弱侧增益值比较均差异有统计学意义(均P<0.05)。实验组总体和定性划分后的Ⅰ、Ⅱ、Ⅲ型波的强、弱侧增益值比较,均差异有统计学意义(均P<0.05)。实验组的增益值与SN强度的相关性分析,两者同向时呈负相关(rs=-0.63,P<0.05),两者异向时呈正相关(rs=0.34,P<0.05)。结论:单侧前庭周围性眩晕的SPT可出现Ⅰ、Ⅱ、Ⅲ型波,其对应的增益值逐渐降低。SN是SPT增益值和波形的影响因素。

Objective：To analyze the result of smooth pursuit test（SPT）in unilateral vestibular peripheral vertigo and investigate its influencing factors.Method：Smooth pursuit test（SPT）and spontaneous nystagmus（SN）were examined in one hundred and eighty-five patients with unilateral peripheral vertigo（case group）and 51 normal persons（control group）by Video-Nystagmography（Synapsys,France）,and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Result：Of the 185 patients,105（56.8%）,72（38.9%）and 8（4.3%）cases producedⅠ,Ⅱ and Ⅲ waveforms respectively.Of these patients,58（31.4%）demonstrated SN and none had Ⅳ waveform.While of 51 normal persons,38（74.5%）,13（25.5%）persons producedⅠand Ⅱwaveforms repectively and there were no Ⅲ,Ⅳ waveforms or SN.There was statistical significance between the stong and weak gain of SPT in these two groups.Weak gain was significantly different between two groups.The stong and weak gain of SPT in case group were 0.86±0.06,0.80±0.06;0.78±0.09,0.65±0.1;0.68±0.13,0.45±0.12.The relativity between SN and the gain of SPT was positive when they had same direction（rs=-0.63,P0.05）and negative when opposite（rs=0.34,P0.05）.Conclusion：Ⅰ,Ⅱ,Ⅲ three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing.SN is the influencing factor of SPT.