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[良性阵发性位置性眩晕中翻滚试验与Dix-Hallpike试验两种方案优化的探索]

[The exploration on optimization of two alternatives between roll test and Dix-Hallpike test in benign paroxysmal positional vertigo].

作者信息

Ji R, Chen T S, Wang W, Xu K X, Li S S, Wen C, Liu Q, Lin P

机构信息

First Center Clinic College, Tianjin Medical University, Tianjin 300192, China.

Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin 300192, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jun 7;52(6):440-445. doi: 10.3760/cma.j.issn.1673-0860.2017.06.009.

Abstract

To analyze the objective characteristics of roll test and Dix-Hallpike test in benign paroxysmal positional vertigo(BPPV)patients, discussing the premier solution of positional test. A total of 230 patients with BPPV, whereas 170 posterior semicircular canal canalithiasis (PSC-Can) BPPV and 60 horizontal semicircular canal canalithiasis (HSC-Can) BPPV were involved respectively. The induced nystagmus in roll test and Dix-Hallpike test was recorded by video nystagmuo graph (VNG), and the direction, intensity and time characteristics of nystagmus were compared in various BPPV.SPSS19.0 software was used for statistical analysis. Vertically upward nystagmus was induced by hanging in 170 PSC-Can Dix-Hallpike test, and the nystagmus reversed and turned weaker when the subjects came to sit. The intensity of nystagmus at turning to lesion side by hanging and sitting were (30.3±14.1)°/s and (12.6±7.5)°/s respectively, the difference was statistically significant (=20.153, <0.05). However, no nystagmus was induced in PSC-Can roll test. Horizontal nystagmus in the same direction with turning was induced in 60 HSC-Can roll test. The intensity of nystagmus at turning to lesion side and normal side was (42.0±18.0)°/s and (20.3±8.7)°/s respectively, the difference was statistically significant (=12.731, <0.05). Furthermore, horizontal nystagmus in the same direction with turning was induced in 57 HSC-Can Dix-Hallpike. The coherence was 95% with the results of roll test. Dix-Hallpike test can not only be used to diagnose PSC-Can, but also induce nystagmus in HSC-Can effectively. Whereas the roll test only show significance in diagnosing HSC-Can. To avoid uncomfortable stimulation to patients as much as possible, we suggest to use Dix-Hallpike test at first, and to judge whether using roll test based on the result of the horizontal nystagmus.

摘要

分析良性阵发性位置性眩晕(BPPV)患者翻滚试验和Dix-Hallpike试验的客观特征,探讨位置试验的首选方案。共纳入230例BPPV患者,其中后半规管耳石症(PSC-Can)BPPV患者170例,水平半规管耳石症(HSC-Can)BPPV患者60例。通过视频眼震图(VNG)记录翻滚试验和Dix-Hallpike试验诱发的眼震,比较不同类型BPPV眼震的方向、强度和时间特征。采用SPSS19.0软件进行统计分析。170例PSC-Can患者行Dix-Hallpike试验悬头位时诱发垂直向上眼震,坐起时眼震方向逆转且减弱。悬头位向患侧及坐起时眼震强度分别为(30.3±14.1)°/s和(12.6±7.5)°/s,差异有统计学意义(=20.153,<0.05)。而PSC-Can翻滚试验未诱发眼震。60例HSC-Can翻滚试验诱发与转向同方向的水平眼震。向患侧及正常侧转向时眼震强度分别为(42.0±18.0)°/s和(20.3±8.7)°/s,差异有统计学意义(=12.731,<0.05)。此外,57例HSC-Can患者行Dix-Hallpike试验诱发与转向同方向的水平眼震。与翻滚试验结果一致性为95%。Dix-Hallpike试验不仅可用于诊断PSC-Can,还能有效诱发HSC-Can的眼震。而翻滚试验仅在诊断HSC-Can时有意义。为尽量避免给患者带来不适刺激,建议先采用Dix-Hallpike试验,根据水平眼震结果判断是否采用翻滚试验。

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