年龄因素对气导声刺激诱发的眼肌和颈肌前庭诱发肌源性电位的影响

Effects of aging on air-conducted sound elicited ocular vestibular-evoked myogenic potential and cervical vestibular-evoked myogenic potential

目的 了解年龄增长对正常人气导声刺激（air conducted sound,ACS）诱发的眼肌前庭诱发肌源性电位（ocular vestibular-evoked myogenic potentia,oVEMP）和颈肌前庭肌源性诱发电位（cervical vestibular-evoked myogenic potential,cVEMP）的影响.方法 选择不同年龄段健康人97名（194耳）作为研究对象,男41名（82耳）,女56名（112耳）;年龄4～ 83岁,平均（45.7±19.3）岁,分为≤10岁,11 ～30岁,31～50岁,51 ～70岁,＞70岁组共5个年龄段（年龄以周岁计）.以气导短纯音为刺激声,分别进行气导声刺激诱发的oVEMP和cVEMP检测,进行各年龄段波形参数计算和年龄组间的对比.采用SPSS 13.0软件进行统计学分析.结果 全组健康人oVEMP和cVEMP总体引出率分别为72.70％和85.05％.随着年龄增长,无论oVEMP还是cVEMP,均表现出引出率下降、阈值增高和振幅减低的特点.＞ 70岁年龄组健康人oVEMP引出率低至15.00％ （3/20）,cVEMP引出率低至45.00％ （9/20）.结论 随着年龄增长,健康人前庭耳石器反射通路表现出机能下降的趋势.由于气导声刺激诱发的oVEMP和cVEMP在70岁以上年龄组引出率过低,其在高龄人群前庭疾病检测中的适用性还有待于进一步深入探讨.

Objective To identify the aging effects on air-conducted sound （ACS） elicited ocular vestibular-evoked myogenic potential （oVEMP） and cervical vestibular-evoked myogenic potential （cVEMP） in normal Chinese population.Methods Nighty-seven normal subjects （194 ears） were recruited for conventional ACS-oVEMP and ACS-cVEMP examinations.The candidates＇age were 4-83 years old （Ave.± SD,45.7 ± 19.3）,41 male and 56 female,divided into 5 groups according to age.500 Hz short tone burst was employed for examinations.Thresholds were identified and the parameters of the responses to 100dB nHL were calculated and compared among groups.SPSS 13.0 software was used to analyze the date.Results As the age growing,the response rate for oVEMP decreased.It was recorded 100％ in both ≤ 10-year-old and 11-30-year-old groups,84.00％ in the 31-50-year-old group,48.15％ in the 51-70-year-old group and 15.00％ in the ＞70-year-old group; while that for cVEMP were 100％ in both-≤10-year-old group and 11-30-year-old group,82.00％ in the 31-50-year-old group,77.78％ in the 51-70-year-old group and 45.00％ in the ＞ 70-year-old group.The thresholds elevated and the amplitudes decreased in both examinations with the age growing.However,latencies and latency-intervals of both oVEMP and cVEMP examinations displayed minor difference among groups except that nI latency of oVEMP prolonged with age growing.Conclusions With the age growing,the otolithic end organ input pathways degenerate in normal subjects,as shown that ACS elicited oVEMP and cVEMP responsed less with higher threshold and smaller amplitude.The extremely low response rates of both VEMPs in the ＞70-year-old group in this study indicates that VEMPs can only provide limited diagnostic information among very old people in clinical practice.