外侧半规管良性阵发性位置性眩晕患者假性自发性眼震的特点及临床意义

摘要

Objective To investigate characteristics of pseudo-spontaneous nystagmus( PSN)in patients with lateral canal benign paroxysmal positional vertigo( LC-BPPV)and to explore the clinical significance. Methods We enrolled 199 patients who were admitted into Renmin Hospital,Hubei University of Medicine from August 2007 to August 2013. Caloric test was conducted and infrared video nystagmus recorder was used to observe spontaneous nystagmus. According to the results, subjects were divided into PSN group(n=34)and non-PSN group(n=165). All patients were treated with Barbecue rotation test. ResuIts The two groups were not significantly different(P﹥0. 05)in gender,LC-BPPV type,the duration of symptoms and the duration of geotropic and apogeotropic symptoms(P﹥0. 05). The two groups were significantly different in age,the ill ear,treatment duration and the treatment duration of geotropic and apogeotropic symptoms(P﹤0. 05). There were 21 patients in PSN group who had a same direction in PSN and Barbecue rotation test and their durations of symptoms and treatment were 7. 6 (1. 7)d and 8. 1(2. 1)d;there were 7 patients in PSN group who had different directions in PSN and Barbecue rotation test and their durations of symptoms and treatment were 11. 7(2. 2)d and 12. 2(1. 9)d;the differences were not significant(Z=3. 718,P=0. 421;Z=3. 542,P=0. 529). Multiple linear regression analysis showed that PSN was a factor for the duration of treatment(P﹤0. 05). ConcIusion Spontaneous nystagmus may also occur in LC-BPPV patients without unilateral peripheral vestibular lesion in the sitting position. Occurring of PSN suggests that LC-BPPV patients may need longer treatment duration.%目的：探讨外侧半规管良性阵发性位置性眩晕（ LC-BPPV）患者假性自发性眼震（ PSN）的临床特点，并初步探讨其临床意义。方法选取2007年8月—2013年8月于湖北医药学院附属人民医院收治的LC-BPPV患者199例为研究对象，根据冷热试验和红外线视频眼动记录仪观察自发性眼震结果，将患者分为PSN组（34例）和非PSN组（165例）。患者均采用Barbecue翻滚试验治疗。结果两组性别、LC-BPPV类型、症状持续时间比较，差异无统计学意义（P﹥0.05）。两组geotropic型和apogeotropic型症状持续时间比较，差异均无统计学意义（P﹥0.05）。两组年龄、患侧耳和治疗时间比较，差异有统计学意义（ P﹤0.05）。两组geotropic 型和apogeotropic型治疗时间比较，差异均有统计学意义（P﹤0.05）。PSN组患者21例PSN方向与Barbecue翻滚试验卧位方向一致，症状持续时间和治疗时间分别为7.6（1.7）d和8.1（2.1）d，7例PSN方向与Barbecue翻滚试验卧位方向不一致，症状持续时间和治疗时间分别为11.7（2.2）d和12.2（1.9）d，差异均无统计学意义（Z＝3.718，P＝0.421；Z＝3.542，P＝0.529）。多元线性回归分析显示， PSN进入回归方程，是影响治疗时间的因素（ P﹤0.05）。结论单侧前庭无病变的 LC -BPPV患者在坐位时亦可出现自发性眼震，PSN的发生提示LC-BPPV患者需更长的治疗时间。