梅尼埃病患者前庭内淋巴积水程度与其症状和听觉及前庭功能的相关性分析

The Correlation Analysis of Endolymphatic Hydrops Degree in Vestibule and the Symptoms and Audiovestibular Functions in Patients with Meniere's Disease

严进;成红政;刘爱国;

1:武汉市普仁医院耳鼻咽喉头颈外科

2:华中科技大学同济医学院附属同济医院耳鼻咽喉科

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摘要

目的探讨梅尼埃病患者前庭内淋巴积水程度与其症状、听觉及前庭功能的相关性。方法以34例单侧梅尼埃病患者为研究对象,分别行双侧鼓室内注入稀释8倍的钆喷酸葡胺注射液,24小时后在3T场强下行内耳3DFLAIR序列磁共振成像(three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging,3DFLAIR MRI),评估内淋巴积水程度,并与患者年龄、病程、疾病分级、眩晕发作频率、前庭诱发肌源性电位(VEMP)结果、耳蜗电图结果、冷热试验结果、纯音听阈进行相关性分析。结果 34例患者鼓室注入钆剂后,除5例出现短暂眩晕外,其余患者均未诉不适,未见鼓膜穿孔、感染等并发症。3DFLAIR MRI显示34例患耳前庭外淋巴间隙均清晰显影,可清晰对比显示前庭内淋巴积水征象,其中轻度积水8例,中度积水11例,重度积水15例。34例患者平均听阈为990dB HL,平均为43.56dB HL;冷热试验异常21例,正常13例,诊断率为61.76%;VEMP正常17例,异常7例,未引出10例,诊断率为50%;耳蜗电图异常22例,正常12例,诊断率为64.71%。患者前庭内淋巴积水程度与病程、眩晕发作频率、耳蜗电图结果、冷热试验结果无显著相关性(P>0.05),与患者年龄、纯音听阈、疾病分级、VEMP结果有显著相关性(P<0.01),对应的相关系数分别为0.494、0.568、0.590、0.495。结论梅尼埃病患者前庭内淋巴积水程度与其年龄、疾病分级,纯音听阈及VEMP结果显著相关,与病程、眩晕发作频率、耳蜗电图、冷热试验结果无明显相关性。

关键词

梅尼埃病;3DFLAIR磁共振成像;内淋巴积水;前庭诱发肌源性电位;耳蜗电图

基金项目(Foundation):

作者

严进;成红政;刘爱国;

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梅尼埃病 3DFLAIR磁共振成像内淋巴积水前庭诱发肌源性电位耳蜗电图

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严进成红政刘爱国