10048例眩晕患者规范化双温试验与普通单温试验的临床价值

Clinical Value Discussion of Standard Bithermal Caloric Test (BCT) and Monothermal Caloric Test(MCT) for 10 048 Patients with Vertigo

刘刚;刘博;张祎;毕竞韬;段金萍;赵小燕;刘冬鑫;

1:北京市耳鼻咽喉科研究所

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摘要

目的探讨规范化双耳双温试验在前庭功能评估中的价值及其与单温试验结果的差异。方法回顾性分析10 048例行双温试验的眩晕患者的临床资料和温度试验结果,分别以半规管单侧减弱值(unilateral weakness,UW)≥15%和≥25%作为阳性标准,计算双温试验和单温试验的阳性率及阴性率;分别计算单温试验的敏感度、特异度、正确诊断指数和Kappa值。结果①以UW≥25%作为阳性标准时,双温试验和单温试验的阳性率较UW≥15%作为阳性标准时降低,阴性率升高,差异有统计学意义(P<0.01)。②以UW≥15%作为阳性标准时,单冷试验的敏感度为81.67%,特异度为59.64%,正确诊断指数为0.413,Kappa值为0.422;单热试验的敏感度为83.37%,特异度为52.78%,正确诊断指数为0.362,Kappa值为0.376(P<0.01);③以UW≥25%作为阳性标准时,单冷试验的敏感度为78.87%,特异度为73.53%,正确诊断指数为0.524,Kappa值为0.521;单热试验的敏感度为89.90%,特异度为64.60%,正确诊断指数为0.545,Kappa值为0.449(P<0.01)。结论半规管功能的双侧对称性比应以规范化双耳双温试验结果为判定依据;单温试验存在明确的假阴性和假阳性可能,在临床诊断中不能替代双温试验结果。

关键词

前庭;视频眼震图;单温试验;双温试验

基金项目(Foundation):

首都卫生发展科研专项重点攻关项目(2018-1-1091)

作者

刘刚;刘博;张祎;毕竞韬;段金萍;赵小燕;刘冬鑫;

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前庭视频眼震图单温试验双温试验

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刘刚刘博张祎毕竞韬段金萍赵小燕刘冬鑫