前庭自旋转实验非对称性异常对眩晕性疾病临床诊断意义分析

Clinical Significance Analysis of Asymmetry from Vestibular Autorotation Test in Vestibular Diseases

目的探讨前庭自旋转试验(vestibular autorotation test,VAT)非对称性异常的临床意义。方法纳入眩晕或头晕症状且VAT显示非对称异常的患者,按照VAT水平增益值分为非对称异常合并水平增益降低组,非对称异常合并水平增益增高组和非对称异常合并水平增益正常组。比较3组疾病构成情况。结果研究共纳入108例患者,其中非对称异常合并水平增益降低组56例,其中45例(80.4%)为前庭外周性疾病,11例(19.6%)为前庭中枢性疾病;非对称异常合并水平增益增高组35例,均为前庭中枢性疾病(100%);非对称异常合并水平增益正常组17例,15例(88.2%)为前庭外周性疾病,2例(11.8%)为前庭中枢性疾病。3组间疾病构成有显著差异。其中非对称异常合并水平增益增高组的前庭中枢性疾病发病率显著高于非对称异常合并水平增益降低组和非对称异常合并水平增益正常组(均P<0.001)。结论 VAT非对称性异常多提示前庭外周性疾病,但非对称性异常合并水平增益增高提示前庭中枢性疾病可能。

Objective To investigate the clinical significance of asymmetry results from vestibular autorotation test （VAT）. Methods All patients were divided into 3 groups by horizontal gain： abnormal asymmetry and decreased horizontal gain group （Group A）, abnormal asymmetry and increased horizontal gain （Group B）, and abnormal asymmetry and normal horizontal gain （Group C）. Then the disease constitution of the 3 groups were compared. Results Group A （n=56） had 45 patients （80.4%） of peripheral vestibular diseases and 11 patients （19.6%） of central vestibular diseases. All the patients （100%） in group B （n=35） had central vestibular diseases. Group C （n=17） had 15 patients （88.2%） of peripheral vestibular diseases and 2 patients （11.8%） of central vestibular diseases. The incidence rates of central vestibular disease in Group B were significantly higher than those in Groups A and C （P＜0.001）. Conclusion The abnormal asymmetry mostly indicated peripheral vestibular diseases, however, the abnormal asymmetry with increased horizontal gain suggested the possibility of central vestibular diseases.