视频头脉冲试验联合温度试验评估前庭性偏头痛患者半规管功能

Clinical Observation of Video Head Pulse Test Combined with Caloric Test in Evaluating Semicircular Canal Function in Patients with Vestibular Migraine

龚为群;何杰平;范坤;侍洁;蒋怀礼

1:上海市徐汇区中心医院耳鼻喉科

2:上海中冶医院耳鼻喉科

3:复旦大学附属中山医院耳鼻咽喉头颈外科

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摘要

目的分析确诊型前庭性偏头痛(definite vestibular migraine, dVM)与可疑型前庭性偏头痛(probable vestibular migraine, pVM)患者视频头脉冲试验(video head impulse test, vHIT)和温度试验结果。方法选取2018年1月至2021年7月于上海中冶医院眩晕门诊就诊的dVM患者40例和pVM患者40例。所有入组对象进行问卷调查，收集患者性别、年龄、头痛类别(侧别、搏动性、影响因素)、伴随症状(畏光、畏声)、疼痛视觉模拟评分(visual analogu scale, VAS)、眩晕类别、眩晕持续时间。对两组患者进行vHIT试验及温度试验，记录vHIT试验中三对半规管功能增益值及不对称性比，以及温度试验中半规管功能眼震慢相速度(slow phase velocity, SPV)、半规管单侧减弱值(unilateral weakness, UW)、优势偏向(directional preponderance, DP)以及固视抑制指数(fixation index, FI)。采用SPSS 20.0统计软件对数据进行统计分析。结果冷热试验：dVM组FI为48.35%±5.28%,pVM组为15.02%±5.80%,两组差异有统计学意义(P=0.038);dVM组UW为31.82%±2.70%,pVM组为31.50%±3.27%,两组差异无统计学意义(P=0.975);dVM组DP为17.44%±1.92%,pVM组为27.64%±2.15%,两组差异无统计学意义(P=0.264);vHIT:dVM组水平半规管增益不对称比为48.35%±5.2%,pVM组为15.02%±5.80%,两组差异有统计学意义(P=0.045);dVM组前半规管增益不对称比为9.71%±1.25%,pVM组为9.64%±1.76%,两组差异无统计学意义(P值=0.986);dVM组后半规管增益不对称比为10.06%±2.71%,pVM组为11.71%±1.70%,两组差异无统计学意义(P=0.579)。结论 dVM与pVM患者vHIT水平半规管不对称比及温度试验固视抑制指数存在一定的差异。

[Abstract]Objective To study the results of video head impulse test (vHIT) and caloric test in patients with definite vestibular migraine (dVM) and probable vestibular migraine (pVM). Methods A total of 40 patients with dVM and 40 patients with pVM were recruited from the vertigo clinic of Shanghai MCC hospital from January 2018 to July 2021. All subjects completed questionnaire, including patient gender, age,headache category (side,pulsatility,influencing factors), accompanying symptoms (photophobia, fear of sound), pain visual analog scale (VAS), vertigo category and vertigo duration. Two groups of patients were subjected to vHit test and caloric test. The gain value and asymmetry ratio of three pairs of semicircular canal function in vHIT test were collected. The slow phase velocity (SPV)， unilateral weakness (UW)， directional preference (DP)and fixation inhibition index(FD)of semicircular canal function in caloric test were collected.SPSS 20.0 statistical software was used to analyze the data.Results FI(%):Group dVM:48.35±5.28，Group pVM:15.02±5.80，(P=0.038);UW(%):Group dVM:31.82士2. 70，Group pVM: 31.50土3.27，(P=0.975); DP(%): Group dVM: 17.44士1.92,Group pVM: 27.64士2. 15,(P=0. 264); The asymmetry ratio(%) of horizontal semicircular canal gain of vHIT: Group dVM; 48. 35上5. 2, Group pVM: 15.02士5. 80,(P=0. 045). The asymmetry ratio of anterior semicircular canal gain(%):Group dVM: 9.71土1. 25, Group pVM: 9.64士1. 76,(P=0. 986). The asymmetry ratio(%) of the latter half of the regulatory gain: Group dVM: 10. 06土2. 71, Group pVM: 11.71士1. 70 (P=0. 579). Conclusion There were differences in semicircular canal asymmetry ratio and fixation inhibition index of horizontal semicircular canal in vHIT and caloric test between dVM and pVM patients.

关键词

前庭性偏头痛;视频头脉冲试验;眩晕

基金项目(Foundation):

上海市宝山区科学技术委员会科技创新专项资金项目（19-E-49）

作者

龚为群;何杰平;范坤;侍洁;蒋怀礼

参考文献

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