动态平衡感觉统合试验在外周前庭疾病平衡评估中的应用

Clinical values of the sensory organization test in vestibular diseases

目的 探讨动态平衡台感觉统合试验（sensory organization test,SOT）在前庭外周性损伤后平衡功能评估中的应用价值.方法 2013年1月至2014年10月,天津市第一中心医院前庭外周性眩晕患者112例为试验组,分别完成SOT和冷热试验两项前庭平衡功能测评.健康志愿者42名为对照组,完成SOT测评.以SOT综合评分及前庭觉、本体觉和视觉的分别评分（权重）、冷热试验诱发眼震慢相角速度非对称值（unilateral weakness,UW）为观测指标,比较分析试验组SOT与冷热试验之间、SOT在试验组与对照组间的结果特征.采用SPSS17.0软件进行统计学处理.结果 试验组SOT和冷热试验结果异常者分别为37例（33.0％）和72例（64.3％）,两项试验阳性率比较,差异具有统计学意义（x^2 =18.06,P＜0.05）;对照组SOT综合评分[（81.93±5.19）分]及各个感觉权重均在正常范围,与试验组综合评分[（77.24 ±9.18）分]比较,差异有统计学意义（Z=-3.039,P＜0.05）.试验组SOT综合评分与各个感觉权重结果存在三种组合形式：SOT综合评分及各个感觉权重均正常者75例（67.0％）,中位病程30.0 d;综合评分正常而感觉权重有异常者20例（17.9％）,中位病程10.5 d;综合评分异常且感觉权重有异常者17例（15.2％）,中位病程6.7d.结论 动态平衡台SOT能够客观反映前庭外周性损伤后的机体平衡重建状态和重建过程中前庭觉、本体觉及视觉的权重变化特征,对于制定个性化平衡康复方案,评估平衡代偿及康复效果具有指导作用.

Objective To explore the clinical values of Sensory Organization Test （SOT） of dynamic posturography in the diagnosis of peripheral vertigo.Methods A total of 112 patients with peripheral vertigo were retrospectively analyzed.All the patients firstly underwent the inspection of SOT followed by caloric test.The results were conducted a comparative analysis.Assessments of SOT evaluated the patient＇s effective use of visual,vestibular,and somatosensory information for balance control during a variety of changing task conditions.The unilateral weakness was selected as assessment parameter of caloric test.Fourty-two healthy subjects were selected as control group underwent the dynamic posturography.Results Among the 42 cases of control group,results of SOT in dynamic posturography were normal.The SOT composite scores owned a significant difference between control and peripheral vertigo subjects.Among the 112 cases with peripheral vertigo,results of SOT in dynamic posturography were abnormal in 37 cases,with a sensitivity of 33.0%;caloric test was abnormal in 72 cases,with a sensitivity of 64.3%.There existed a significant difference between dynamic posturography and caloric test.Conclusion SOT is a key test in dynamic posturography that reflects the balance reconstruction after peripheral injury,and provides information about the integration and proportion of the visual,proprioceptive,and vestibular components of balance.