耳石器官功能检查的正常值及年龄因素的影响

Normal values of otolith function tests and age-related changes

目的：探讨健康人群眼球旋转（DFA）、静态主观垂直视觉（SSVV）、颈肌前庭诱发肌源性电位（cVEMP）和眼肌前庭诱发肌源性电位（oVEMP）的正常值以及年龄因素的影响。方法：纳入171名健康人作为研究对象，以10岁为间隔分为7个年龄组。分别进行眼底照相、SSVV和前庭诱发肌源性电位检查，统计各组的正常值并分析年龄因素的影响。结果：健康人群的DFA与SSVV，两者各自均左右对称且与年龄无关（P〉0．05）。在cVEMP中，引出率在60岁之后下降（P〈0．01）；阈值每隔20岁递增（P〈0．05）；振幅除41～50岁组与51～60岁组无差别外（P=0．93），随年龄每隔10岁递减（P〈0．05）；超过70岁者的P1潜伏期明显延长（P〈0．01）。在oVEMP中，引出率在60岁之后下降（P〈0．01）；阈值在10～20岁组与21～30岁组最低（P〈0．05），超过70岁阈值最高（P〈0．01）；振幅在10～20岁组最高（P〈0．05），60岁以后减低（P〈0．05）；超过70岁，P1潜伏期和N1潜伏期则明显延长（P〈0．01）。同一个体的两耳之间的阈值、振幅和潜伏期均无明显差别（P〉0．05）。结论：随着年龄增长，健康人群的DFA与SSVV并不呈现明显的变化；而cVEMP与oVEMP则出现引出率与振幅的下降、阈值的增高与潜伏期延长的变化。

Objective：To explore the normal values of otolith function tests and age-related changes in health volunteers. Method：One hundred and seventy-one health volunteers were distributed to seven age groups, all subjects accepted otolith function tests, including fundus photography, static subjective visual vertieal（SSVV）, cervical vestibular evoked myogenic potential（cVEMP）and ocular vestibular evoked myogenic potential（oVEMP）, the fundus photographs was used to measure the disc-fovea angle（DFA）. DFA, SSVV and VEMPs were analyzed and compared among groups. Result：For DFA and SSVV,there were no significant differences either between different ages or between the two eyes in one individual（P〉0.05）. For eVEMP, the detection rate declined with age over 60 years old（P〈0.01） ; the eVEMP threshold increased with every 20 years old（P〈0.05） ; and the cVEMP amplitude decreased with every 10 years old （P〈0. 05） ,however, there was an exception that no significant difference was found between 41-50 ye.ars old and 51-60 years old groups（P=0.93）;the cVEMP P1 latency prolonged with age over 70 years old（P〈0.01）. For oVEMP, the detection rate also declined with age over 60 years old（P〈0.01） ; the oVEMP threshold was lowest at the age less than 30 years old and the largest threshold was found at the age over 70 years old（P〈0.01）; consistently, the oVEMP amplitude was found largest at the age less than 20 years old and lowest at the age over 60 years old（P〈0.05）. The P1 and N1 latencies were found significantly longer in the group of over 70 years old than other groups（P〈0.01）. No significant difference was found between both sides in one individual for oVEMP threshold,amplitude or latency （P〉0.05）. Conclusion：In health volunteers,there were no obvious aged related changes in DFA and SSVV. However, the detection rate, threshold, amplitude and latency of cVEMP and oVEMP greatly changed with age.