蜗性听力损失对前庭脊髓反射影响的研究

Influence on vestibulospinal reflex caused by cochlear sensorial hearing loss

目的通过姿势描记图检查对耳蜗性聋患者的前庭脊髓反射(vestibulospinal reflex,VSR)功能作定性及定量研究,以探讨耳蜗性聋对静态平衡能力的影响。方法用人体姿态平衡仪记录正常对照组和耳蜗性聋组重心移动的各项参数,主要包括重心晃动的路径总长和晃动速度,并将耳蜗性聋组重心移动的各项参数与正常对照组进行比较。结果听力损失≥71 dBHL的重度耳蜗性聋患者,重心轨迹晃动的路径总长长度明显延长,晃动速度明显增快,与正常对照组比较,路径总长之间的差异有统计学意义(P<0.05);闭眼状态下,晃动速度之间的差异有统计学意义(P<0.01)。听力损失为41～70 dBHL的耳蜗性聋组病例与正常对照组之间的差异无统计学意义(P>0.05)。结论重度耳蜗性聋(听力损失≥71 dBHL)的患者,前庭脊髓反射功能异常,静态平衡能力减弱。

Objective To evaluate the influence of cochlear sensorial hearing loss on static balance via quantitative and qualitative analysis of vestibulospinal reflex with posturographic examination.Methods Static posturography was applied to normal subjects（28 cases） and patients with cochlear sensorial hearing loss（66 cases） separately and the length of locus and velocity of postural sway were recorded.Results For patients with cochlear sensorial hearing loss of greater than or equal to 71 dBHL,the length of locus and velocity of postural sway were significantly increased.The differences were statistically significant（P0.05）.When eyes closed,the difference of velocity of postural sway between normal subjects and patients with sensorial hearing loss of greater than or equal to 71 dBHL was more significant（P0.01）.The differences between normal subjects and patients with sensorial hearing loss of less than 71 dBHL were statistically insignificant（P0.05）.Conclusion In patients with cochlear sensorial hearing loss（≥71 dBHL）,vestibulospinal reflex is abnormal and their ability to keep stability weakens.