后半规管和水平半规管BPPV变位实验时眼震特点初步分析

Characteristics of nystagmus in position test for posterior canal and horizontal canal benign paroxysmal positional vertigo

摘要:

目的分析良性阵发性位置性眩晕（BPPV）患者变位实验中眼震的参数特征，探讨其临床意义和产生机制。方法回顾性分析398 例BPPV 患者，应用视频眼震电图记录变位实验诱发的眼震，分析比较后半规管BPPV（PC-BPPV）和水平半规管BPPV（HC-BPPV）变位实验各头位眼震方向、潜伏期和持续时间等参数特点。结果BPPV 患者398 例，其中PC-BPPV 290 例，占73.1%（290/398），271 例诱发出向地、旋转、向上型眼震，平均潜伏期（26.36±18.70）s，眼震持续时间平均（10.88±8.89）s；HC-BPPV 103 例，占25.8%（103/398），76例诱发出水平向地性眼震，平均潜伏期（0.67±0.68）s，眼震持续时间平均（25.34±20.12）s，24 例HC-BPPV 水平离地性眼震患者平均潜伏期（3.59±2.01）s，平均持续时间（52.30±40.21）s。与PC-BPPV 相比，水平向地性HC-BBPV 在潜伏期、眼震持续时间差异具有统计学意义（t =21.13 和8.89，P =0.007 和0.002）；水平离地性HC-BPPV 在潜伏期差异无统计学意义（t =0.08，P =0.945），而在持续时间差异具有统计学意义（t =6.10，P =0.003）。结论在变位实验中，PC-BPPV 眼震潜伏期长于向地性HC-BPPV，不一定长于水平性HC-BPPV，但持续时间短于所有类型HC-BPPV。

Abstract:

Objective To investigate the clinical significance and formation mechanism by analyzing the characteristics of the nystagmus from benign paroxysmal positional vertigo (BPPV) in positioning test. Methods There were 398 BPPV cases for retrospective analysis. The video -nystagmography was utilized to record the nystagmus in positioning tests. The direction, latent period and duration of nystagmus during the positioning tests of posterior canal BPPV (PC-BPPV) and horizontal canal BPPV (HC-BPPV) were analyzed and compared. Results There were totally 398 BPPV cases, Among the 290 cases (73.1%) with posterior canal BPPV, geotropic, rotative,and antrorse nystagmus was induced in 271 cases, with the mean latency period of (26.36 ±18.70) s and the mean duration of (10.88 ±8.89) s. Among the 103 cases with HC-BPPV (25.8%), horizontal geotropic nystagmus was induced in 76 cases, with the mean latency period of (0.67 ±0.68) s and the mean duration of (25.34 ±20.12) s.And in the 24 cases with horizontal apogeotropic nystagmus, the mean latency period was (3.59 ±2.01) s, and the mean duration was (52.30 ±40.21) s. Compared with PC-BPPV, the latent period (t = 21.13,P = 0.007) and the duration ( t= 8.89, P= 0.002) were statistically different in HC-BPPV with geotropic nystagmu; and the duration (t=6.10, P= 0.003) was staticstical different, but the latent period was not significantly different ( t= 0.08,P = 0.945)in HC-BPPV with apogeotropic nystagmus. Conclusions In positioning test, the latent period of PC-BPPV is longer than that of HC-BPPV with geotropic nystagmus, but not necessarily longer than that of HC-BPPV with apogeotropic nystagmus. The nystagmus duration of PC-BPPV is shorter than that of HC-BPPV with geotropic nystagmus and apogeotropic nystagmus.