头脉冲抑制试验在单侧前庭神经炎患者中的应用价值

The application value of suppression head impulse paradigm in vestibular neuritis

目的:研究前庭神经炎患者头脉冲抑制试验(SHIMP)的参数特征,探讨SHIMP在前庭神经炎患者中的应用价值。方法:选择我科门诊就诊的20例前庭上神经炎患者,利用视频头脉冲检查仪获取前庭上神经炎患者头脉冲试验(HIMP)及SHIMP增益值。结果:全部患者HIMP检查中患侧甩头均可引出代偿性扫视,健侧甩头均引出无代偿性扫视;SHIMP检查中健侧甩头均可引出反代偿性扫视,患侧甩头均引出无反代偿性扫视或仅有微弱扫视。前庭神经炎患者HIMP患侧、健侧增益值分别为0.56±0.15和0.99±0.13;SHIMP患侧、健侧增益值分别为0.45±0.13和0.9±0.13。HIMP患侧及健侧增益均较SHIMP患侧及健侧增益大,差异有统计学意义(P<0.05)。患侧与健侧HIMP及SHIMP增益间差异均有统计学意义(P<0.01)。结论:SHIMP联合HIMP可评估前庭神经炎前庭功能损伤及保留情况,也可动态监测患者前庭代偿情况。

Objective：To study the parameters of the suppression head impulse paradigm of vestibular neuritis and explore the application value of suppression head impulse paradigm in vestibular neuritis.Method：Twenty patients with vestibular neuritis in our outpatient clinic were selected.The HIMP and SHIMP gain of unilateral vestibular neuritis patients were detected by video pulse detector.Result：All patients with HIMP examination in the affected side can elicit compensatory saccade,the healthy side with no compensatory saccade;SHIMP examination in the healthy side can elicit anti-compensatory saccade,the affected side without compensatory saccade or weak saccades.The HIMP gain of affected side and healthy side of patients with vestibular neuritis were 0.56±0.15 and 0.99±0.13 respectively,and the SHIMP gain of affected side and healthy side of patients with vestibular neuritis were 0.45±0.13 and 0.9±0.13 respectively.The gain of the affected side and the healthy side of HIMP was larger than those of SHIMP,and the difference was statistically significant（P〈0.05）.The differences of HIMP and SHIMP gain between the affected side and the healthy side were statistically significant（P〈0.01）.Conclusion：Video head impulse test combined with suppression head impulse paradigm can evaluate vestibular function injury and residual retention in vestibular neuritis,and can also dynamically monitor vestibular compensation in patients.