闭目原地踏步试验对头晕／眩晕患者病因筛查的诊断价值

Diagnostic values of Unterberger test in etiology screening of patients with dizziness/vertigo

目的探讨闭目原地踏步试验对头晕／眩晕初步病因筛查的诊断价值。方法对564例头晕／眩晕患者采用原地闭目踏步试验、眼球震颤检测、Dix-Hallpike试验，分析闭目原地踏步试验对头晕／眩晕病因初步筛查的诊断价值。结果本组患者闭目原地踏步试验发生倾倒72例（12．8％），其中合并眼球震颤68例（94．4％），诊断为：前庭周围病变59例，其他13例；偏向一侧310例（55．0％），其中合并眼球震颤43例，Dix-Hallpike阳性102例，诊断为：位置性眩晕41例、前庭周围病变4例、复发性前庭病168例、椎基底动脉供血不足50例、精神性头晕26例、其他原因21例；踏步试验阴性182例（32．3％），Dix-Hallpike阳性96例，诊断为：位置性眩晕94例、精神性头晕58例、椎基底动脉供血不足12例、复发性前庭病6例，其他12例。头晕／眩晕前庭周围病变、复发性前庭病、椎基底动脉供血不足患者闭目原地踏步试验多为阳性表现（χ2=34．97、58．18、16．20，P〈0．01），而位置性眩晕、精神性头晕患者多为阴性表现（χ2=14．11、8．26，P〈0．01）。结论闭目原地踏步试验结合眼球震颤、Dix-Hallpike检查是快速筛查头晕／眩晕患者初步病因的有效方法。

Objective To explore the diagnostic values of Unterberger test in etiology screening of patients with dizziness/vertigo. Methods Unterberger, nystagmus and Dix-Hallpike test were carried out in 564 patients with dizziness and vertigo and diagnostic values of Unterberger test in etiology screening of dizzi- ness and vertigo analyzed. Results During Unterberger test dumping occurred in 72 patients （12.8%）, dumping complicated with nystagmus did in 68 ones （94.4%）, 59 ones were diagnosed as vestibular pe- ripheral lesions and 13 other; 310 patients dumped to one side （55.0%）, dumping complicated with nys- tagmus did in 43 ones, Dix-Hallpike tests were positive in 102 ones, 41 ones were diagnosed as positional vertigo, 4 vestibular peripheral lesions, 168 recurrent vestibulopathy, 50 vertebro-basilar artery insuffi- ciency （VBI） , 26 psychic dizziness, and 21 other; Unterberger tests were negative in 182 （32.3%） and Dix-Hallpike positive 96, 94 ones were diagnosed as positional vertigo, 58 psychic dizziness, 12 VBI, 6 re- current vestibulopathy, and 12 other. Unterberger tests of patients with dizziness/vertigo caused by ves- tibular peripheral lesions, recurrent vestibulopathy and VBI were positive, those of positional vertigo and psychic dizziness negative. Conclusion Unterberger test in combination with nystagmus and Dix-Hallpike test is a quick and effective method to screen initial causes of dizziness/vertigo patients.