临床内科杂志 ›› 2019, Vol. 36 ›› Issue (10): 673-675.doi: 10.3969/j.issn.1001-9057.2019.10.008

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闭目踏步试验对良性阵发性位置性眩晕患者受累半规管侧别的判定价值

  

  • 出版日期:2019-10-15 发布日期:2019-10-30

Value of Fukuda stepping test for involvement lateralization semicircular canal of benign paroxysmal positional vertigo patients

  • Online:2019-10-15 Published:2019-10-30

摘要: 目的 评价闭目踏步试验对良性阵发性位置性眩晕(BPPV)患者受累半规管侧别的判定价值。方法 选取于我院眩晕门诊就诊的BPPV患者200例,收集其一般资料,所有患者均进行闭目踏步试验和变位试验,比较闭目踏步试验的偏斜方向和受累半规管侧别方向是否相符。结果200例BPPV患者中闭目踏步试验结果发生偏斜者140例(70.0%),无偏斜者60例(30.0%)。在140例偏斜的BPPV患者中,闭目踏步试验的方向与受累半规管侧别相符者82例(58.6%),不相符者58例(41.4%)。200例BPPV患者中,后半规管受累者131例(65.5%),水平半规管管耳石受累者44例(22.0%),水平半规管壶腹嵴耳石受累者24例(12.0%),前半规管受累者1例(0.5%),其中后半规管、水平半规管管耳石和水平半规管壶腹嵴耳石受累侧别与闭目踏步试验偏斜方向的相符比例间比较差异无统计学意义(P=0.630)。年龄≤50岁与>50岁的患者其闭目踏步试验偏斜方向与受累侧别相符、不符和无偏斜构成比比较差异无统计学意义(P=0.998);发病时间≤1天与>1天的患者其相符、不符和无偏斜构成比比较差异有统计学意义(P=0.024)。结论 对于发病早期(发病时间≤1天)的BPPV患者,闭目踏步试验的偏斜方向与受累半规管侧别具有很好的相符率,有一定的定侧价值。

关键词: 良性阵发性位置性眩晕; 闭目踏步试验; 变位试验

Abstract: Objective To evaluate the value of Fukuda stepping test for involvement lateralization semicircular canal of benign paroxysmal positional vertigo(BPPV) patients.Methods A total of 200 cases of BPPV patients admitted in the dizziness clinic of our hospital were observed.The general information was collected,and each patient took both the Fukuda stepping test and positioning test.The correlation between the results of Fukuda stepping test and the affected semicircular canal were compared.Results A total of 140 patients(70.0%) were positive of Fukuda stepping test,while 60 patients(30.0%) were negative in 200 BPPV patients.Among the 140 BPPV patients with positive Fukuda stepping test,there were 82 patients(58.6%) in which the direction of Fukuda stepping test was consistent with the side of affected semicircular canal while 58 patients(41.4%) were not.There were 131 patients (65.5%) of posterior semicircular canal involved,44 patients(22%) of geotropic horizontal semicircular canal involved,24 patients(12%) of apogeotropic horizontal semicircular canal involved and 1 patients(0.5%) of superior semicircular canal involved in 200 BPPV patients.There was no statistically significant difference between coincidence ratios of the posterior semicircular canal,geotropic horizontal semicircular canal and apogeotropic horizontal semicircular canal involved direction which were related to the deviation direction of Fukuda stepping test(P=0.630).There was no statistically significant difference in the constituent ratios of consistent or not and nagative in the direction of Fukuda stepping test and the involved direction between patients whose age≤50 years old and >50 years old(P=0.998).There was statistically significant difference in the constituent ratios of consistent or not and nagative between patients whose onset≤1 day and >1 day(P=0.024).Conclusion For the BPPV patients of the early stage(onset≤1 day),the deviation direction of the Fukuda stepping test has a good coincidence ratio with the affected semicircular canal side.Fukuda stepping test has some value for involvement lateralization of BPPV.

Key words: Benign paroxysmal positional vertigo; Fukuda stepping test; Positioning test