文章摘要
朱艳含 ,钱果 ,秦文静 ,方毅 ,徐姣 ,周涛 ,常丽英.急性单侧外周前庭病变病因初步探究[J].神经损伤功能重建,2024,(2):81-85
急性单侧外周前庭病变病因初步探究
Preliminary Research on the Etiology of Acute Unilateral Peripheral Vestibular Dysfunction
  
DOI:
中文关键词: 急性单侧外周前庭病变  双温检查  视频头脉冲试验  钆造影  激素治疗
英文关键词: acute unilateral peripheral vestibular dysfunction  double-temperature test  video head impulse test  gadolinium angiography  hormone therapy
基金项目:襄阳市科技局科研 立项(增强后延迟 扫描在单侧外周前 庭病变发病机制中 的价值,No. 2021Y L13);襄阳市科技 局 立 项 重 点 课 题 (眩晕患者个体化 前庭康复评估及治 疗,No. 2022YL16 A);襄阳市中心医 院立项课题(眩晕 患者前庭康复的个 体化评估及治疗, No. 2022YB16)
作者单位
朱艳含1 ,钱果2 ,秦文静1 ,方毅1 ,徐姣1 ,周涛1 ,常丽英1 1. 湖北文理学院附 属 医 院/襄 阳 市 中 心医院神经内科 2. 武汉科技大学医 学部医学院 
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中文摘要:
      目的:通过分析急性单侧外周前庭病变(acute unilateral peripheral vestibular dysfunction,AUPVD)患 者的基本信息、前庭功能、影像学检查、治疗效果等指标,探究AUPVD的可能病因、累及部位。方法:收集 2022年2月~4月我科收治的符合纳入标准的AUPVD患者36例的临床资料,其中30例接受视频头脉冲 (vHIT)检查,26例接受激素治疗,3例行迷路钆造影增强扫描。分析、比较患者的检查结果及脑血管病危险 因素。结果:30例行vHIT检查的患者中,结果异常25例,其中12例(48%)水平半规管vHIT异常,但前管 正常;部分迷路钆造影增强检查的患者可见病变侧前庭迷路强化信号,未观察到前庭神经的强化信号;26 例使用激素治疗的患者中,17例(65.4%)效果较好,9例(34.6%)效果欠佳,后者平均年龄及至少合并1项脑 血管病危险因素占比明显高于前者(P<0.05)。结论:AUPVD的病因可能包括炎性、缺血等多种机制;可能 累及前庭神经、前庭迷路等多处部位。
英文摘要:
      To explore the potential etiologies and affected sites in acute unilateral peripheral vestibular dysfunction (AUPVD) by analyzing patients’basic information, vestibular function, imaging examinations, and therapeutic outcomes. Methods: Clinical data of 36 AUPVD patients admitted to our department from February to April 2022 who met the inclusion criteria were collected. Among these, 30 underwent video head impulse test (vHIT), 26 received steroid treatment, and 3 had gadolinium contrast-enhanced labyrinthine MRI. The examination results and risk factors for cerebrovascular diseases were retrospectively analyzed and compared. Results: In the 30 patients who underwent vHIT, 25 showed abnormal results; among them, 12 cases (48%) had abnormal horizontal canal vHIT while the anterior canal was normal; some patients who underwent gadolinium-enhanced labyrinthine MRI showed enhancement signals in the lesion side vestibular labyrinth, but no enhancement signals in the vestibular nerve were observed; among the 26 patients treated with steroids, 17 (65.4%) responded well, while 9 (34.6%) had poor responses. The latter group had a significantly higher average age and a higher proportion of at least one cerebrovascular disease risk factor (P<0.05). Conclusion: The etiology of AUPVD may include various mechanisms such as inflammation and ischemia; it may affect multiple sites including the vestibular nerve and vestibular labyrinth.
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