冷热试验与耳蜗电图在梅尼埃病诊断中的意义

Significance of electrocochleogram and vestibular bithermal caloric test in diagnosis of Meniere's disease

目的:探讨耳蜗电图与双温试验在梅尼埃病的诊断中的作用。方法:32例梅尼埃病患者均接受前庭双温试验(冷热气,美国智听红外视频眼动记录系统)和耳蜗电图检查(双侧;美国,Nicolet诱发电位记录系统)。双温试验半规管轻瘫(CP)>20%为异常;耳蜗电图-SP/AP比值>0.40为异常。结果:所有患者中,半规管轻瘫(CP)异常者共18例,CP异常的百分率为56.3%;耳蜗电图异常者共27例,阳性率为84.4%;其差异有统计学意义,耳蜗电图更为灵敏(P<0.05)。其中有7例患者双侧耳蜗电图均表现异常。CP与耳蜗电图均异常15例;CP正常,耳蜗电图异常12例;CP异常,耳蜗电图正常3例;二者均正常2例。结论:梅尼埃病是一种进行性病变过程,临床表现错综复杂,梅尼埃病的诊断应以临床症状为基础,结合耳蜗电图、前庭双温试验检查,可达到早期诊断、提高确诊率的目的。

Objective：To investigate the effect of electrocochleogram（EcochG） and vestibular bithermal caloric test in diagnosis of Meniere＇s disease.Methods：Patients with Meniere＇s diasese were given electrocochleogram （EcochG） and vestibular bithermal caloric test.Results：For all the 32 patients,there were 18 cases whose canal paresis （CP） were abnormal,the percentage of the abnormal was 56.3%; the positive ratio of electrocochleogram and canal paresis had significant difference（ P〈0.05）. 27 cases were abnormal for electrocochleogram,the percentage of the abnormal was 84.4%,while 7 cases were abnor -mal in double ears. 15 patients were abnormal for all the electrocochleogram and canal paresis; 12 cases were abnormal of electrocochleogram,while they were normal of canal paresis; only 3 cases were abnormal of canal paresis,while they were normal of electrocochleogram; 2 cases were normal for all the electrocochleogram and canal paresis.Conclusion：The course of Meniere＇s disease was progressive,while the clinical situation is complicated.Diagnosis of Meniere＇s disease should be mainly based on the medical history.If it can combine with electrocochleogram ,bithermal caloric test,the diagnosis would be earlier and more accurate.