良性阵发性位置性眩晕患者视频头脉冲试验结果分析

Video head impulse test for benign paroxysmal positional vertigo

目的评估良性阵发性位置性眩晕(BPPV)患者半规管高频功能情况。方法确诊为单侧半规管BPPV患者360例,包括后半规管管石症120例,水平半规管管石症120例,水平半规管嵴顶结石症120例,健康体检对照组120例,4组受试者均完成视频头脉冲试验(vHIT),以vHIT出现补偿性眼跳为异常指标,分析4组受试者vHIT试验结果。结果 BPPV患者vHIT异常率(17.8%)与正常对照组(3.3%)比较,差异有统计学意义(χ~2=16.174,P=0.001)。但3组BPPV患者vHIT异常率分别为16.7%、20.0%和16.67%,其差异无统计学意义(P>0.05)。病程>3周的患者其vHIT异常率(47.7%)明显高于病程<3周者(8.1%),病程>3周各组患者其vHIT异常率差异具有明显统计学意义(χ~2=6.991,P=0.008)。结论 BPPV患者vHIT异常率增加,但vHIT异常率不受所累及半规管及亚型的明显的影响,而受到BPPV病程的明显影响。

Objective To evaluate the high frequency function of semicircular canal in patients with benign parox- ysmal positional vertigo （BPPV）. Methods A total of 360 patients diagnosed as having single semicircular canal BPPV were included, including 120 cases with posterior semicircular canal canalithasis （PSC-Can）, 120 with horizontal semicircular canal canalithasis （HSC-Can） and 120 with horizontal semicircular canal cupulolithiasis （HSC-Cup）, and 120 healthy subjects as control. All patients and healthy subjects received video head impulse test （vHIT）. Presence of compen- satory saccade on vHIT was considered as abnormal. Results The abnormal vHIT rate （17.8%） was increased in patients with BPPV compared with control group （3.3%）（P 〈 0.05）, but there was no significant differences between the 3 groups of patients with PSC-Can （16.7%）, PSC-Cup （20.0%） and HSC-Can （16.7%） （P 〉 0.05）. The rate （47.7%） of abnormal vHIT in patients with BPPV disease courses more than 3 weeks was higher than that （8.1%） in patients with BPPV disease courses less than 3 weeks （P 〈 0.05）. Conclusion Abnormal vHIT can be found in patients with BPPV, regardless of PSC- Can, LSC-Can or LSC-Cup. Existence of abnormal vHIT is closely associated with disease course of BPPV, with an increased rate of abnormal vHIT in patients with disease course more than 3 weeks.