Dynamic visual acuity screening test results analysis of 25 patients with peripheral vertigo
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摘要: 目的 观察外周性眩晕患者动态视敏度(dynamic visual acuity, DVA)筛查试验结果并探讨其临床意义。 方法 48名健康志愿者作为对照组，25例外周性眩晕患者作为试验组，其中前庭神经炎患者12例，Hunt综合征患者1例，突发性聋伴眩晕5例，双侧前庭功能下降患者7例。进行水平与垂直动态视敏度筛查试验。将试验组与对照组的水平、垂直动态视敏度丢失行数进行比较; 对试验组内水平、垂直丢失行数进行比较; 将试验组内单、双侧前庭功能分别与对照组进行比较。 结果 对照组水平DVA丢失行数中位数为1.5，垂直DVA丢失行数中位数为1.0; 试验组水平DVA丢失行数中位数为6.0，垂直DVA丢失行数中位数为5.0。对照组和试验组的水平、垂直丢失行数比较差异均有统计学意义(P＜0.01)。试验组组内水平和垂直丢失行数比较差异有统计学意义(P＜0.01)。将试验组分为单侧前庭功能下降组(18例)和双侧前庭功能下降组(7例)，与对照组进行对比，3组两两比较，水平和垂直丢失行数比较差异均有统计学意义(P＜0.01)，对照组水平和垂直DVA丢失行数明显分别低于单侧前庭功能下降组和双侧前庭功能下降组，单侧前庭功能下降组的水平和垂直丢失行数明显低于双侧前庭功能下降组(P＜0.01)。25例外周性眩晕患者水平丢失行数与双侧水平半规管vHIT均值之间呈显著相关关系(P＜0.01); 垂直丢失行数与双侧垂直半规管vHIT均值之间呈显著相关关系(P＜0.01)。 结论 DVA筛查试验是现有外周前庭功能检查特别是vHIT测试的有效补充，能快速评估前庭功能下降患者的2 Hz前庭眼反射损伤程度。Abstract: Objective To observe the results of dynamic visual acuity screening tests in patients with peripheral vertigo and explore its clinical significance. Methods The number of 48 healthy volunteers were enrolled as control group and 25 peripheral vertigo patients as experimental group. In the experimental group, there are 12 patients with vestibular neuritis, 1 patient with Hunt syndrome, 5 patients with sudden deafness with vertigo and 7 patients with bilateral vestibular dysfunction. Horizontal and vertical dynamic visual acuity screening tests were performed on them. The number of lost rows of horizontal and vertical dynamic visual acuity was compared between the control group and the experimental group to figure out if there is a statistical difference. The number of lost rows of horizontal and vertical dynamic visual acuity was compared within the experimental group to figure out if there is a statistical difference. The two groups of 18 cases of unilateral vestibular function decline and 7 cases of bilateral vestibular function decline in the experimental group were compared with the control group, and figure out if there is a statistical difference. Results The median number of lost rows of horizontal dynamic visual acuity in 48 healthy volunteers was 1.5 and median number of lost rows of vertical dynamic visual acuity was 1.0 in the control group. The median number of lost rows of horizontal dynamic visual acuity of 26 healthy volunteers was 6 and median number of lost rows of vertical dynamic visual acuity was 5 in the experimental group. Compared to the experimental group, the number of lost rows both have statistical significance in horizontal and vertical dynamic visual acuity(P < 0.01). The comparison of horizontal and vertical lost rows within the test group also have statistical significance(P < 0.01). Twenty five patients with exceptional vestibular disease in the experimental group were divided into unilateral vestibular function reduction group(n=18) and bilateral vestibular function reduction group(n=7). Compared with the control group, there was significant differences in the number of horizontal and vertical lost rows(P < 0.01) within the three groups. After pairwise comparison, the number of lost rows of horizontal and vertical in the control group was significantly lower than that in the unilateral vestibular function reduction group and the bilateral vestibular function reduction group(P < 0.01). There was a highly significant correlation between the number of horizontally lost rows of DVA and the mean vHIT values of bilateral horizontal semicircular canals in 25 patients(P < 0.01); and a highly significant correlation between the number of vertically lost rows of DVA and the mean vHIT values of vertical semicircular canals in 4 groups bilaterally(P < 0.01). Conclusion The Dynamic Visual Acuity Screening Test is a useful addition to existing tests of peripheral vestibular function, particularly the vHIT test, and provides a rapid assessment of the extent of 2 Hz VOR impairment in patients with reduced vestibular function.
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Key words:
- dynamic visual acuity /
- peripheral vertigo /
- vestibular function
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表 1 对照组与试验组丢失行数比较
组别 例数 水平丢失行数 垂直丢失行数 Z P 试验组 25 6(5，8) 5(3，6) -3.683 ＜0.001 对照组 48 2(1，2) 1(0，1) -4.990 ＜0.001 Z -6.914 -6.880 P ＜0.001 ＜0.001 
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表 2 对照组与单侧前庭功能下降组、双侧前庭功能下降组比较
组别 例数 水平丢失行数 垂直丢失行数 健康组 48 2(1，2) 1(0，1) 单侧前庭功能下降组 18 5(4，6)1) 4(3，5)1) 双侧前庭功能下降组 7 9(8，10)1)2) 7(6，10)1)2) χ2 49.660 49.303 P ＜0.001 ＜0.001 与对照组比较，1)P＜0.01；与单侧前庭疾病组比较，2)P＜0.01。
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