耳蜗电图SP/AP面积比在梅尼埃病诊断中的应用研究

Application of SP/AP area ratio of electrocochleography in the diagnosis of Meniere's disease

目的：分析比较耳蜗电图（electrocochleography,ECoch G）中总和电位（summating potential,SP）与动作电位（action potential,AP）的幅度比和面积比两种方法在梅尼埃病（Meniere’s disease,MD）诊断中的应用价值。方法：样本总量为96名成人受试者（共测试123耳）。将其分为3组：对照组由56名听功能正常的受试者组成（共测试76耳）,确诊MD组25人（单耳21人,双耳4人,共测试29耳）;疑似MD组15人（单耳12人,双耳3人,共18耳）。将对照组的SP/AP幅度比与面积比的95%参考值上限作为阳性参考值,分别计算确诊MD组和可疑MD组的振幅比和面积比阳性率,比较两种方法阳性率的差异性及统计学意义。结果：对照组所得SP/AP幅度比95%参考值范围为：0.01～0.32,以〉0.32为阳性标准;SP/AP面积比95%参考值范围为：0.68～1.82,以〉1.82为阳性标准。确诊MD组中,幅度比的阳性检出率为14.29%（15/105）,面积比的阳性检出率为25.71%（27/105）,面积比阳性率高于振幅比阳性率（χ^2=6.050,P=0.014）。可疑MD组中,幅度比阳性率为16.67%（3/18）;面积比阳性率为77.78%（14/18）。两者阳性率差异有统计学意义（χ^2=9.091,P=0.003）,其面积比阳性率高于振幅比阳性率。结论：同SP/AP幅度比相比较,面积比在梅尼埃疾病的诊断中更具有优势。

Objective：To analyze and compare summating potential（SP）and action potential（AP）in electrocochleogram for diagnosing Meniere＇s disease（MD）. Methods：All 96 adults（123 ears）were divided into three groups：control group,MD diagnosed group,MD suspected group. Control group was consisted of 56 subjects with normal function of hearing（76 ears were tested）;MD diagnosed group was consisted of 25 subjects（29 ears from 21 subjects with single ear and 4 subjects with double ears）;MD suspected group was composed of 15 subjects（18 ears from 12 subjects with single ear and 3 subjects with double ears）. The SP/AP amplitude ratio and SP/AP area ratio of MD suspected group and MD diagnosed group were compared. Results：The SP/AP amplitude ratio from 95%reference of control group ranged from 0.01 to 0.32,and the positive standard was higher than 0.32;the SP/AP area ratio from 95%reference was 0. 68-1. 82,and the positive standard was higher than 1.82. In MD diagnosed group,the positive rate of the SP/AP amplitude ratio was 14.29%（15 out of 105）;the positive rate of SP/AP area ratio was 25.71%（27 out of 105）;the positive ratio of SP/AP area ratio was higher than that of amplitude ratio（χ^2=6.050,P=0.014）. In MD suspected group,the positive rate of SP/AP amplitude ratio was 16.67%（3 out of 18）and the positive rate of SP/AP area ratio was 77.78%（14 out of 18）. There were statistical differences between SP/AP area ratio and amplitude ratio（χ^2=9.091,P=0.003）;the positive ratio of SP/AP area ratio was higher than that of SP/AP amplitude ratio. Conclusion：SP/AP area ratio is superior to SP/AP amplitude ratio in diagnozing MD.