单冷试验用于前庭功能筛查的可行性分析

Feasibility analysis of monothermal caloric test in the screening of vestibular function

目的探讨单冷试验用于前庭功能筛选的价值及在临床评估前庭功能的可行性。方法回顾性分析以眩晕为主诉的149例眩晕症患者的温度试验结果,分析患者温度试验结果与单冷试验结果的相关性及单冷试验的灵敏度和特异度。结果149例眩晕患者男90例、女59例,年龄22~70(中位数46)岁。根据文献研究报道,以温度试验半规管轻瘫(CP)值为20%作为正常参考值,得出温度试验与单冷试验结果呈线性关系(r=0.872,P<0.001)。以CP值≥20%为温度试验的异常标准,温度试验作为金标准,受试者工作特征(ROC)曲线分析,单冷试验正常者的ROC曲线下面积为0.894(95%CI 0.833~0.939,P<0.001),通过约登指数确定临界点为20%,单冷试验结果大于20%为异常,灵敏度为84.62%,特异度为84.54%。结论单冷试验在前庭功能筛查的可靠性高,是一种灵敏的筛查工具,在临床中结合眼震电图将单冷试验作为筛查工具,将缩短患者检查时间及减少不适感。

Objective To explore the value of monothermal caloric test in the screenig of vestibular function and the feasibility in the clinical evaluation of vestibular function.Methods The caloric test results of 149 vertigo patients presenting with vertigo as the main complaint were retrospectively analyzed.The correlation between caloric test results and monothermal caloric test results were analyzed.The sensitivity and specificity of the monothermal test were analyzed too.Results Among 149 vertigo patients,90 cases were male and 59 female,aged 22-70 years old with a median age of 46 years old.According to literature review,the CP value of caloric test of 20% was regarded as the normal reference value,and the results of caloric test and monothermal caloric test showed a linear relationship(r = 0.872,P < 0.001).The CP value of caloric test of ≥ 20% was considered as the abnormal standard and caloric test was used as the gold standard.The area under ROC curve for patients with normal monothermal caloric test results was 0.894(95% CI 0.833-0.939,P < 0.001).The shreshold value of CP was determined as 20% according to the Youden index.The CP value of monothermal caloric test of > 20% was regarded as abnormal result.The sensitivity was calculated as 84.62% and 84.54% for the specificity.Conclusions Monothermal caloric test yields a high reliability in vestibular function screening.As a sensitive screening tool,the combined use of monothermal caloric test and electronystagmography can shortern the examination time and mitigate discomforts of vergito patients.