急性前庭神经炎视频头脉冲抑制试验参数与DHI评分改变的相关性

Correlation between parameters of suppression head impulse paradigm and changesin DHI score in acute vestibular neuritis

目的探讨视频头脉冲抑制试验(suppression head impulse paradigm,SHIMP)的参数与眩晕障碍量表(dizziness handicap inventory,DHI)评分改变的相关性,以期通过SHIMP的相关参数来评估急性前庭神经炎的眩晕程度及预后。方法选取急性前庭神经炎患者33例,行DHI量表评估、vHIT和SHIMP检查,病程达2周且不伴自发性眼震时再次行DHI量表评估。以第二次DHI评分的下降幅度,作为疗效指标(efficacy index,EI)。将所有患者按照疗效分为显效、有效和无效3组。比较3组患者SHIMP的前庭眼反射增益值及反代偿扫视波出现率之间的差异。结果显效组13例,有效组11例,无效组9例。①在各组水平半规管增益均值比较中,显效组增益均值为(0.50±0.11);有效组增益均值为(0.44±0.12);无效组增益均值为(0.34±0.08)。显效组与无效组增益均值差异有统计学意义(P<0.01)。水平半规管增益值与EI呈正相关(r=0.5385,P<0.01);②在各组水平半规管反代偿扫视波出现率均值比较中,显效组反代偿扫视波出现率均值为(51.23±19.59);有效组反代偿扫视波出现率均值为(33.64±17.68);无效组反代偿扫视波出现率均值为(13.78±11.81)。各组间两两比较均差异有统计学意义(P<0.05)。水平半规管反代偿扫视波出现率与EI呈正相关(r=0.6582,P<0.01)。结论急性前庭神经炎患者SHIMP检查中的增益值以及反代偿扫视波出现率与DHI评分下降幅度密切相关。

Objective To explore the correlation between the parameters of suppression head impulse paradigm(SHIMP)and changes in dizziness handicap inventory(DHI)scores.Additionally,to evaluate the degree of vertigo and prognosis of patients with acute vestibular neuritis through SHIMP parameters.Methods Thirty-three patients with acute vestibular neuritis were enrolled for DHI evaluation,vHIT and SHIMP.A secondary DHI score were evaluated after after two weeks,once patients no longer exhibited spontaneous nystagmus.The decrease in the second DHI score was used as the efficacy index(EI).All patients were divided into significantly effective group,effective group and ineffective group based on EI.Differences of the VOR gain values of SHIMP and the anti-compensatory saccade were compared among the three groups.Results There were 13 cases in the significant effective group,11 cases in the effective group,and 9 cases in the ineffective group.①The mean gain of the horizontal semicircular canal in the significant effective group,the effective group,and the ineffective group was(0.50±0.11),(0.44±0.12),and(0.34±0.08),respectively.The difference between the significant effective group and the ineffective group was statistically significant(P<0.01).The gain of horizontal semicircular canal was positively correlated with EI(r=0.5385,P<0.01)。②The occurrence rate of the anti-compensatory saccade in the significant effective group,the effective group,and the ineffective group was(51.23±19.59),(33.64±17.68),and(13.78±11.81),respectively.Pairwise comparisons between each group showed statistical significance(P<0.05).The occurrence rate of anti-compensatory saccade was positively correlated with EI(r=0.6582,P<0.01).Conclusion The horizontal semicircular canal gain and the occurrence rate of the anti-compensatory saccade in SHIMP for patients with acute vestibular neuritis were closely correlated with decrease in DHI score.