前庭诱发肌源性电位诊断糖尿病前庭神经损伤的临床价值

摘要

Objective To explore the values of vestibular evoked myogenic potential (VEMP) in the diagnosis of vestibular nerve impairment in type 2 diabetes mellitus patients.Methods Forty-two cases (84 ears)of diabetes mellitus patients and 42 cases (84 ears)normal subjects as the control group were enrolled from 2014 to 2015.Both the patients and normal subjects underwent conventional air-conducted ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears.The results were compared between the patients and normal subjects.A commercially available software package, SPSS19.0, was used for statistical analysis.Results In 84 ears of the normal subjects,oVEMP was present in 70 ears, the educible rate was 83.3％ (70/84).cVEMP was present in 74 ears, and the educible rate was 88.1％ (74/84).In 84 ears of the diabetes mellitus patients, oVEMP was present in 49 ears, with the educible rate of 58.3％ (49/84).cVEMP was present in 52 ears, with the educible rate of 61.9％ (52/84).The educible rate in the control group was significantly higher than the diabeticgroup(oVEMP: x2=12.71, P＜0.05;cVEMP: x2=15.37, P＜0.05).In the diabetic group, the mean values of both oVEMP and cVEMP P1, N1 latencies were significantly longer when compared to the control group (P ＜ 0.05).No significantly statistical difference was found in oVEMP and cVEMP parameters (threshold, latency interval and amplitude) between groups (P ＞ 0.05).Conclusions Vestibular nerve was impaired in diabetes mellitus patients in some degree.VEMP examinations could be useful in the diagnosis of vestibular nerve impairment in type 2 diabetes mellitus patients.%目的 探讨前庭诱发肌源性电位(vestibular evoked myogenic potential,VEMP)在诊断糖尿病前庭神经损伤方面的临床价值.方法 对2014年5月至2015年5月收治的42例(84耳)2型糖尿病患者和同期42名(84耳)健康人进行眼肌前庭诱发肌源性电位(ocular VEMP,oVEMP)和颈肌前庭诱发肌源性电位(cervical VEMP,cVEMP)检查,比较两组间oVEMP和cVEMP的引出率及各波潜伏期和振幅的差异,并应用SPSS 19.0软件进行统计分析.结果 健康对照组84耳中70耳引出oVEMP,引出率为83.3％;74耳引出cVEMP,引出率为88.1％.糖尿病组84耳中49耳引出oVEMP,引出率为58.3％;52耳引出cVEMP,引出率为61.9％.健康对照组VEMP的引出率明显高于糖尿病组,差异具有统计学意义(oVEMP:x2=12.71,P＜0.05;cVEMP:x2=15.37,P＜0.05).糖尿病组与健康对照组相比,oVEMP和cVEMP各波潜伏期延长,差异有统计学意义(P值均＜0.05);而波间期、振幅和阈值等参数组间比较,差异无统计学意义(P值均＞0.05).结论 2型糖尿病患者存在一定程度的前庭神经损伤,VEMP可作为早期发现糖尿病患者前庭功能损伤的有效手段.