颈扭曲试验加Valsalva's动作强化颈性血管性眩晕的检出

Cervical Twisting Test Plus Valsalva's Increasing the Detection of Cervical Vascular Dizziness

目的 探讨颈扭曲试验加入Valsalva s动作对颈性血管性眩晕检出效果的影响。方法 46例颈性眩晕患者行颈扭曲试验 ,阴性者在颈扭曲试验到位后加做Valsalva s动作。观察阳性症状检出率。在经颅超声多普勒脑血流图检查下重复以上过程 ,计算双侧血流不对称指数。资料与 3 0例正常对照比较。用卡方和卡方直接概率法及t检验作统计学处理。结果 试验组颈扭曲试验阴性 2 9例 ,阳性 17例 ,阳性检出率 3 6.95 %。阴性者加入Valsalva s动作后阳性症状出现率增加 17.3 9% (P <0 .0 5 ) ,与对照组比较检出率有显著性差异 (P <0 .0 1)。试验组颈扭曲试验加入Valsalva s动作前后双侧椎动脉血流不对称指数有明显差异 (P <0 .0 5 )。结论 颈性眩晕患者做颈扭曲试验时加入Valsalva s动作能加强扭曲试验效果 。

Objective To investigate the influence of cervical twisting test plus Valsalva's on the detection of cervical vascular dizziness.Method 46 patients with cervical dizziness accepted cervical twisting test,negative cases accepted Valsalva's additionally.The positive rate of clinical symptoms was observed.Then previous process was repeated under TCD to calculate interhemispheric asymmetry index(AI) of vertebral artery.The data were compared with those from 30 health controls.Results 29 cases were negative and 17 cases were positive in cerical twisting test in trial group.The positive percentage of dizziness symptoms in trail group was 36.9% and raise 17.36%(P<0.05) after the addition of Valsalva's.There was a significant difference compared with the normal control(P<0.01).There was a significant difference in the value of AI before and after the additional Valsalva's in trial group(P<0.05).Conclusions Cervical twisting test plus Valsalva's could strenthen the effect of the test and raise the positive rate.