耳蜗电图诊断梅尼埃病的灵敏度研究

毛忠瑶; 刘磊; 彭利艳; 周良强; 刘爱国

doi:10.13201/j.issn.1001-1781.2014.13.013

耳蜗电图诊断梅尼埃病的灵敏度研究

- 1. 华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科(武汉, 430022);
- 2. 京山县人民医院耳鼻咽喉科

详细信息

通讯作者: 刘爱国,E-mail:aiguoliu309@163.com

中图分类号: R764.3

收稿日期: 2014-04-28

Electrocochleography in the diagnosis of Meniere's disease

- 1. Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China;
- 2. Department of Otolaryngology, Jingshan People's Hospital

More Information

Corresponding author: LIU Aiguo, E-mail: aiguoliu309@163.com

Received Date: 28 April 2014

摘要

摘要: 目的：探讨耳蜗电图在梅尼埃病（MD）诊断中的应用价值。方法：将测试对象分为确诊、可能和疑似MD组，将可能和疑似MD组合并为可疑MD组。依据纯音听阈测试结果对确诊MD组患耳按听力损失程度进行病情分级。采用短声（click）和1 000、2 000、4 000 Hz 3种频率tone burst（TB）分别对测试耳进行耳蜗电图测试，并计算和电位（SP）与听神经复合动作电位（AP）的振幅比值（SP/AP），同时采用由click刺激声引出的AP疏波和密波潜伏期的差值（AP shift）辅助诊断。分别计算不同刺激声不同测试方法的诊断阳性率，比较MD的诊断阳性率。结果：确诊MD组click SP/AP阳性率为41.2%，TB 1 000、2 000、4 000 Hz阳性率分别为80.4%、72.5%、37.3%，AP shift阳性率为45.1%。配对χ²检验显示，TB 1 000 Hz与click SP/AP阳性率比较、TB 2 000 Hz与click SP/AP阳性率比较均差异有统计学意义（均P<0.01），其中TB 1 000 Hz诊断阳性率最高，即灵敏度最高。确诊MD组与可疑MD组患耳click SP/AP阳性率分别为41.2%和12.0%（P<0.05），AP shift阳性率分别为45.1%和8.0%（P<0.01），χ²检验显示2组间click SP/AP和AP shift阳性率差异有统计学意义。结论：耳蜗电图在MD诊断及鉴别诊断中作用显著，特别是采用1 000 Hz和2 000 HzTB刺激声，其诊断灵敏度高达80.4%和72.5%。AP shift也被证明是一种有效的测量方法，在辅助诊断MD中作用显著。
- 耳蜗电图 /
- 梅尼埃病
Abstract: Objective: To evaluate clinical value of electrocochleography in diagnosing the Meniere's disease.Method: Patients were saperated as having definite, probable and possible Meniere's disease according to the 1995 AAOHNS guidelines.Then set the probable and possible Meniere's disease as a suspected group. We used four different stimulus(clicks, 1 000 Hz tone burst, 2 000 Hz and 4 000 Hz tone burst) to record electrocochleo-graphy. Those patients in each group received electrocochleography examination, and summating potential (SP)/action potential (AP) ratios were calculated. A prolonged action potential latency shift (AP shift) evoked by rarefaction and condensation clicks was also measured. Result: The click SP/AP positive rate in definite Meniere's disease group was 41.2%, tone burst at 1 000 Hz, 2 000 Hz, 4 000 Hz were respectively 80.4%, 72.5%, 37.3%, AP shift positive rate was 45.1%. Using McNemar test, the positive rate of tone burst 1 000 Hz (χ²=15.04,P<0.01) and that of tone burst 2 000 Hz (χ²=8.65,P<0.01) were statistically significant different when compared with that of click SP/AP, besides the tone burst at 1 000 Hz yielded has the highest sensitivity. The click SP/AP positive rate in suspected group and definite group were respectively 12% and 45.1%(χ²=6.610,P<0.05) and AP shift positive rate of them were respectively 8.0% and 41.2%(χ²=10.460,P<0.01).By chis-quare test, the positive rates of click SP/AP and AP shift between these two groups were statistically significant different. Conclusion: Electrocochleography is a reliable test in the diagnosis of Meniere's disease. Compared with clicks, tone burst significantly has a higher sensitivity, especially at 1000Hz and 2000Hz frequencies. A prolonged action potential latency shift evoked by rarefaction and condensation clicks is also a useful addition to diagnosis Meniere' disease.
- electrocochleography /
- Meniere's disease

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