后半规管和水平半规管BPPV患者站立平衡功能分析

周任红; 刘波; 张甦琳; 刘东冬; 刘晶晶; 冷杨名; 孔维佳

doi:10.13201/j.issn.1001-1781.2015.22.009

后半规管和水平半规管BPPV患者站立平衡功能分析

- 华中科技大学同济医学院附属协和医院耳鼻咽喉科(武汉, 430022)
基金项目:
耳源性眩晕机制及诊治方法方案研制(国家科技支撑计划)(No:2012BAZ12B02)

前庭中枢代偿机制及眩晕疾病规范化诊断与康复治疗方案研究(国家科技支撑计划)(No:2007BAI18B13)

眩晕机制及平衡功能检查与康复治疗设备研制[国家高技术研究发展计划(863计划)](No:2008AA02Z428)

详细信息

通讯作者: 孔维佳,E-mail:entwjkong@hust.edu.cn

中图分类号: R764

收稿日期: 2015-08-16

The balance function of the patients with benign paroxysmal positional vertigo during standing

- Department of Otolaryngology, the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: KONG Weijia, E-mail: entwjkong@hust.edu.cn

Received Date: 16 August 2015

摘要

摘要: 目的: 研究后半规管和水平半规管BPPV患者的动态站立平衡功能及静态站立平衡功能。方法: 本研究采用感觉整合试验(SOT)评估41例后半规管BPPV(PC-BPPV)患者、11例水平半规管BPPV(HC-BPPV)患者以及44例健康对照受试者的动态站立平衡功能,基于受试者在20 s测试过程中晃动的角度计算平衡得分,根据平衡得分给出平衡三联的感觉分析。通过感觉相互作用与平衡的改良临床试验(mCTSIB)测试3组受试者即条件平均重心(COG)晃动速度,评估其静态站立平衡功能。分析PC-BPPV及HC-BPPV患者的站立平衡功能的特点,探索后半规管及水平半规管在姿势控制中的作用。结果: PC-BPPV组患者在SOT试验中的SOT4(73.69±10.20)、SOT5(57.28±14.19)和SOT6(54.78±13.10)的得分明显低于对照组(81.91±9.27、67.16±9.53、63.11±12.47,均P<0.01)。PC-BPPV组患者视觉(0.78±0.11)和前庭觉(0.60±0.15)得分与对照组(0.86±0.09、0.71±0.10,均P<0.01)相比有显著降低。mCTSIB试验中,PC-BPPV组患者在海绵垫上睁眼(0.88±0.26)和闭眼状态时的晃动速度(2.45±1.03)明显高于对照组(0.74±0.31、1.74±0.48,P<0.05)。HC-BPPV患者组在SOT和mCTSIB试验中与对照组相比均未检测到姿势控制异常。HC-BPPV组跟对照组比较,本体觉、视觉、前庭觉、视优势得分均差异无统计学意义。结论: PC-BPPV患者的姿势稳定性下降,而HC-BPPV姿势控制不受影响。SOT和mCTSIB都可以检测出由于后半规管功能障碍引起的姿势失衡。
- 良性阵发性位置性眩晕 /
- 静态平衡 /
- 动态平衡 /
- 站立平衡 /
- 姿势控制
Abstract: Objective: The purpose of the study was to investigate the balance function of the patients with benign paroxysmal positional vertigo (BPPV) during standing.Method: In this study 41 patients with posterior semicircular canal BPPV (PC BPPV) and 11 patients with horizontal semicircular canal BPPV (HC BPPV) were recruited. Dynamic balance during standing was measured in Sensory Organization Test (SOT). Static balance during standing was measured in modified Clinical Test of Sensory Interaction and Balance (mCTSIB). Data of BPPV patients were compared to that from 44 normal controls.Result: Scores of the patients with PC BPPV were lower than that of the normal controls in the last three test conditions of SOT. Patients with PC BPPV demonstrated greater sway velocity in stance on foam with eyes open and eyes closed in mCTSIB. No postural deficit was observed in neither SOT nor mCTSIB when the patients with HC BPPV were compared to the normal controls.Conclusion: Disorders of the horizontal semicircular canal do not influence postural control. Both dynamic and static posturography can detect the postural imbalance caused by posterior semicircular canal dysfunction.
- benign paroxysmal positional vertigo /
- static balance /
- dynamic balance /
- standing balance /
- postural control

HTML全文

参考文献(7)

[1]	刘波,孔维佳,姚琦,等.后半规管良性阵发性位置性眩晕患者于本体觉被干扰时的姿势平衡[J].听力学及言语疾病杂志,2008,16(1):23-26.
[2]	中华耳鼻咽喉头颈外科杂志编辑委员会.良性阵发性位置性眩晕的诊断依据和疗效评估[J].中华耳鼻咽喉头颈外科杂志,2007,42(2):163-164.
[3]	BHATTACHARYYA N, BAUGH R, ORVIDAS L,et al.Clinical practice gu ideline:benign paroxysmal positional vertigo[J].Otol Head Neck Surg,2008,139:S47-81.
[4]	FIFE T, IVERSON D, LEMPERT T et al. Practice parameter:therapies for benign paroxysmal positional vertigo (an evidence-based review):report of the Quality Standards Subcommittee of the American Academy of Neurology[J].Neurology,2008,70:2067-2074.
[5]	KORRES S, GKORITSA E, GIANNAKAKOU-RAZELOU D, et al. Vestibular evoked myogenic potentials in patients with BPPV[J].Med Sci Monit,2011,17:CR42-47.
[6]	HONG S M,PARK D C, YEO S G,et al.Vestibular evoked myogenic potentials in patients with benign paroxysmal positional vertigo involving each semicircular canal[J].Am J Otolaryngol,2008,29:184-187.
[7]	NAKAHARA H, YOSHIMURA E, TSUDA Y,et al. Damaged utricular function clarified by oVEMP in patients with benign paroxysmal positional vertigo[J].Acta Otolaryngol,2013,133:144-149.