A study of the effect of hot and cold gas perfusion sequence on caloric test results
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摘要: 目的 研究冷热试验冷热气灌注顺序对试验结果是否存在影响，为冷热试验的规范和质控提供依据。 方法 应用视频眼震图和冷热气刺激仪进行冷热试验。将健康志愿者30例(60耳)分为两组，每组15例(30耳)。第1组先进行冷气刺激再行热气刺激(先冷后热组)，第2组先行热气刺激再行冷气刺激(先热后冷组)。观察比较两组受试者在冷热气试验不同灌注顺序下的眼震最大慢相角速度(SPV)、半规管轻瘫(CP)和优势偏向(DP)的差异。 结果 先冷后热组和先热后冷组受试者诱发眼震强度相近。两组受试者SPV值组内分析，同侧耳不同温、同温不同侧耳诱发眼震强度比较，进行配对t检验，差异均无统计学意义(P>0.05)。两组受试者SPV值组间分析，同侧耳的相同及不同温度刺激诱发眼震强度，进行独立样本t检验，差异均无统计学意义(P>0.05)。两组受试者CP值组间分析，进行独立样本t检验，差异无统计学意义(P>0.05)。两组受试者DP值均在正常范围内，进行独立样本t检验，差异亦无统计学意义(P>0.05)。 结论 冷热气不同灌注顺序对冷热气试验结果不会产生影响，冷热气刺激顺序并非冷热试验的规范和质控研究方向。Abstract: Objective To study whether the warm/cold air injection sequence affects the test results in the caloric test, and provide a basis for the specification and quality control of the caloric test. Methods Video nystagmography and warm and cold air stimulation apparatus were applied for caloric test. Thirty healthy volunteers (60 ears) were divided into two groups of 15 (30 ears) each. The first group was given cold air stimulation followed by warm air stimulation, and the second group was given heat followed by cold. The differences in nystagmus maximal slow phase velocity (SPV), semicircular canal paresis (CP) and dominant preponderance (DP) were compared between the two groups of subjects under different perfusion sequences of caloric test. Results The intensity of nystagmus evoked by subjects in group 1 (cold first and then warm) and group 2 (warm first and then cold) were similar. Paired t-test showed that intra-group analysis of the SPV values of the two groups, comparison of the intensity of nystagmus evoked by different temperatures of the same ear or different sides of ear with the same temperature, the difference was not statistically significant (all P>0.05). Independent samples t-test showed that between-group analysis of SPV values of two groups, the intensity of nystagmus induced by the same and different temperature stimuli in the ipsilateral ear, the difference was not statistically significant (all P>0.05). Independent samples t-test showed that the CP values of the two groups were analyzed between groups, and the difference was not statistically significant (all P>0.05). Independent samples t-test showed that DP values of both groups were in the normal range and the difference was not statistically significant (all P>0.05). Conclusion Different perfusion sequences of warm and cold air do not affect the results of caloric tests, and the order of warm and cold air stimulation is not the normative and quality control research direction of caloric test.
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表 1 两组受试者冷热试验刺激下眼震强度参数
x±s 项目 先冷后热组 先热后冷组 SPV1(°/s) 最小值 最大值 SPV2(°/s) 最小值 最大值 CL 10.2±3.9 3.3 15.6 9.4±5.3 1.2 19.6 CR 9.9±4.0 2.0 16.9 8.6±3.7 1.7 15.1 WL 11.0±3.9 3.0 16.5 9.0±4.2 2.1 19.8 WR 10.7±4.4 2.6 20.0 9.3±3.7 1.9 18.4 
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