Objective The purpose of the study was to evaluate the efficiency of the supine roll test(SRT)and alternative positional tests(APTs)including the bow and lean test(BLT),pseudo-spontaneous nystagmus(PSN),and lying down...Objective The purpose of the study was to evaluate the efficiency of the supine roll test(SRT)and alternative positional tests(APTs)including the bow and lean test(BLT),pseudo-spontaneous nystagmus(PSN),and lying down nystagmus(LDN)to identify the affected side in horizontal canal benign paroxysmal positional vertigo(HC-BPPV).Methods In our prospective study,we performed a testing profile(PSN,BLT,LDN,SRT)on 59 HC-BPPV patients using videonystagmography.We compared the accuracy and sensitivity of these tests in HC-BPPV lateralization.Data from 30 healthy patients were collected as the control group.Results When performing positional tests,the elicited nystagmus coinciding with Ewald’s second law was defined as a“positive response”.In 44 patients with geotropic nystagmus,the rates of positive response in LDN,PSN,and BLT were 22/44(50%),19/44(43%),and 18/44(41%),respectively,while in 15 patients with apogeotropic nystagmus,the positive response rates of these three tests were 10/15(66.7%),9/15(60%),and 4/15(27.00%),respectively.The sensitivity of LDN(54.38%)was higher than that of PSN(47.37%)and BLT(38.60%)but lower than that of SRT(89.47%).Notably,the accuracy rate of PSN(71.8%)was higher than that of the other APTs.In 6 patients with symmetrical nysgtamus during the roll test,5 patients showed a positive response in both LDN and BLT(83.34%),whereas 4 patients showed a positive response in PSN(66.67%).Conclusion All positional tests are helpful for determining the affected side of HC-BPPV,but SRT carries the highest accuracy of lateralization followed by PSN.展开更多
目的探讨传统滚转试验(supine roll test,SRT)、低头-抬头试验(bow and lean test,BLT)和快速轴位滚转试验(rapid axial roll test,RART)在水平半规管良性阵发性位置性眩晕(horizontal semicircular canal benign paroxysmal positional...目的探讨传统滚转试验(supine roll test,SRT)、低头-抬头试验(bow and lean test,BLT)和快速轴位滚转试验(rapid axial roll test,RART)在水平半规管良性阵发性位置性眩晕(horizontal semicircular canal benign paroxysmal positional vertigo,HSC-BPPV)责任半规管判定中的临床价值。方法选取2021年3月至2022年4月西安交通大学第一附属医院HSC-BPPV患者328例,根据不同的变位试验分为SRT组(113例)、BLT+SRT组(104例)和RART+SRT组(111例),BLT+SRT组和RART+SRT组分为2个阶段,第一阶段进行BLT或RART,第二阶段进行SRT。比较不同组别眼震引出率,采用Kappa一致性检验比较BLT/RART与SRT眼震引出结果的一致性。结果328例患者中,男95例,女233例,年龄18~86岁,平均(55.5±13.8)岁。RART+SRT组眼震引出率高于BLT+SRT组和SRT组(94.59%比81.73%比74.34%);RART+SRT组第一阶段眼震引出率、第二阶段SRT眼震引出率、责任半规管判定一致比例均高于BLT+SRT组,差异均有统计学意义(P<0.05);对责任半规管判定一致的患者进行复位治疗,BLT+SRT组痊愈率为92.59%(50/54),RART+SRT组为97.96%(96/98),两组痊愈率的比较,差异无统计学意义(χ^(2)=2.645,P=0.187)。Kappa一致性检验结果显示,RART与SRT在眼震引出率方面具有较好的一致性,一致率达94.59%(Kappa=0.638,P<0.001)。结论RART具有加速度大、安全性好、眼震引出率高的特点,能够有效诱发出HSC-BPPV特征性眼震,提高半规管定侧定位的准确性,为HSC-BPPV的临床实践提供更优化的检查方案,值得在临床中广泛推广。展开更多
基金the National Natural Science Foundation of China(No.81500794,No.81271078 and No.81500791)Scientific Research Project of Hubei Province Health and Family Planning(No.WJ2015MB062).
文摘Objective The purpose of the study was to evaluate the efficiency of the supine roll test(SRT)and alternative positional tests(APTs)including the bow and lean test(BLT),pseudo-spontaneous nystagmus(PSN),and lying down nystagmus(LDN)to identify the affected side in horizontal canal benign paroxysmal positional vertigo(HC-BPPV).Methods In our prospective study,we performed a testing profile(PSN,BLT,LDN,SRT)on 59 HC-BPPV patients using videonystagmography.We compared the accuracy and sensitivity of these tests in HC-BPPV lateralization.Data from 30 healthy patients were collected as the control group.Results When performing positional tests,the elicited nystagmus coinciding with Ewald’s second law was defined as a“positive response”.In 44 patients with geotropic nystagmus,the rates of positive response in LDN,PSN,and BLT were 22/44(50%),19/44(43%),and 18/44(41%),respectively,while in 15 patients with apogeotropic nystagmus,the positive response rates of these three tests were 10/15(66.7%),9/15(60%),and 4/15(27.00%),respectively.The sensitivity of LDN(54.38%)was higher than that of PSN(47.37%)and BLT(38.60%)but lower than that of SRT(89.47%).Notably,the accuracy rate of PSN(71.8%)was higher than that of the other APTs.In 6 patients with symmetrical nysgtamus during the roll test,5 patients showed a positive response in both LDN and BLT(83.34%),whereas 4 patients showed a positive response in PSN(66.67%).Conclusion All positional tests are helpful for determining the affected side of HC-BPPV,but SRT carries the highest accuracy of lateralization followed by PSN.
文摘目的探讨传统滚转试验(supine roll test,SRT)、低头-抬头试验(bow and lean test,BLT)和快速轴位滚转试验(rapid axial roll test,RART)在水平半规管良性阵发性位置性眩晕(horizontal semicircular canal benign paroxysmal positional vertigo,HSC-BPPV)责任半规管判定中的临床价值。方法选取2021年3月至2022年4月西安交通大学第一附属医院HSC-BPPV患者328例,根据不同的变位试验分为SRT组(113例)、BLT+SRT组(104例)和RART+SRT组(111例),BLT+SRT组和RART+SRT组分为2个阶段,第一阶段进行BLT或RART,第二阶段进行SRT。比较不同组别眼震引出率,采用Kappa一致性检验比较BLT/RART与SRT眼震引出结果的一致性。结果328例患者中,男95例,女233例,年龄18~86岁,平均(55.5±13.8)岁。RART+SRT组眼震引出率高于BLT+SRT组和SRT组(94.59%比81.73%比74.34%);RART+SRT组第一阶段眼震引出率、第二阶段SRT眼震引出率、责任半规管判定一致比例均高于BLT+SRT组,差异均有统计学意义(P<0.05);对责任半规管判定一致的患者进行复位治疗,BLT+SRT组痊愈率为92.59%(50/54),RART+SRT组为97.96%(96/98),两组痊愈率的比较,差异无统计学意义(χ^(2)=2.645,P=0.187)。Kappa一致性检验结果显示,RART与SRT在眼震引出率方面具有较好的一致性,一致率达94.59%(Kappa=0.638,P<0.001)。结论RART具有加速度大、安全性好、眼震引出率高的特点,能够有效诱发出HSC-BPPV特征性眼震,提高半规管定侧定位的准确性,为HSC-BPPV的临床实践提供更优化的检查方案,值得在临床中广泛推广。
