| 摘要: |
| 目的 探讨急性单侧前庭病（acute unilateral vestibulopathy, AUVP）患者治疗后患侧水平半规管增益的相关因素。方法 收集2022年1月至2023年12月住院的AUVP患者，将治疗后3个月视频头脉冲试验（video head impulse test, vHIT）中水平半规管增益值未恢复正常且伴有扫视者纳入观察组，反之，水平半规管扫视消失伴增益值恢复正常者纳入对照组，回顾性研究两组患者治疗前和治疗后的临床资料，包括一般临床特点、康复治疗的开始时间、量表评分和vHIT结果，分别用多重线性回归和logistic回归分析和预测治疗后患侧水平半规管增益值的相关因素。结果 共纳入65例患者，其中观察组34例，对照组31例，观察组的病程长于对照组，差异有统计学意义（P<0.001）。观察组康复治疗的开始时间晚于对照组，差异有统计学意义（P<0.001）。观察组患者治疗后的平衡性评分和日常生活能力评分较低、眩晕评分和焦虑抑郁评分较高，差异均有统计学意义（P<0.05）。治疗后患侧水平半规管增益值与病程、康复治疗的开始时间、治疗前的眩晕评分呈线性相关，其标准化回归系数分别为0.769、-1.376、-0.208。将治疗后患侧水平半规管增益值恢复正常作为因变量，纳入年龄、病程、康复治疗的开始时间、治疗前的眩晕评分作为自变量进行Logistic回归分析，结果显示预测模型无统计学意义（P>0.05）。结论 量化治疗后患侧水平半规管的增益值不足以预测AUVP患者的预后，但外周水平半规管的增益值恢复正常与否与AUVP患者的临床预后是相关的，治疗后患侧水平半规管增益未恢复正常者的病程较长、康复治疗的开始时间较晚、焦虑抑郁评分较高，平衡性评分和日常生活能力评分较低，提示预后较差。 |
| 关键词: 前庭神经炎 单侧前庭病 视频头脉冲试验 前庭康复 水平半规管 |
| DOI： |
| 分类号: |
| 基金项目:第五批全国中医临床优秀人才项目，国中医药人教函（2022）1号 |
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| Exploring the relevant factors of horizontal semicircular canal gain on the affected side after treatment in patients with acute unilateral vestibular disease: a retrospective study based on 65 cases |
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周丽丽1, Chen Jing2, Li Fei3, He Zhongyan4, Liu Mingfang5, Zhu Xuzheng5, Wang Ruiming5
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1.Hangzhou Hospital of Traditional Chinese Medicine;2.Department of neurology, Hangzhou Hospital of Traditional Chinese Medicine;3.Department of Neurology, Second Afffliated Hospital of Naval Medical University, Shanghai Changzheng Hospital, Shanghai;4.杭州市中医院神经内科;5.Department of neurology, Hangzhou Hospital of Traditional Chinese Medicine, Zhejiang
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| Abstract: |
| Objective Exploring the relevant factors of horizontal semicircular canal gain on the affected side after treatment in patients with acute unilateral vestibular disease (AUVP). Method Clinical data of patients with AUVP admitted to hospital from January 2022 to December 2023 were collected. Patients with horizontal semicircular canal gain that did not return to normal and accompanied by scanning after treatment for three months were selected as the observation group, while, patients with disappearance of horizontal semicircular canal scanning and normal gain were selected as the control group. Retrospectively analysed the clinical data from two groups of patients before and after treatment, including general clinical characteristics, start time of rehabilitation training, scale score and video head impulse test (vHIT) results. Use multiple linear regression and logistic regression to analyze and predict the related factors of horizontal semicircular canal gain on the affected side after treatment. Result A total of 65 patients with unilateral AUVP were included, there were 34 cases in the observation group, and 31 cases in the control group. The disease course of the observation group was significantly longer than that of the control group, and the difference was statistically significant (P<0.001). The start time of rehabilitation treatment in the observation group was significantly later than that in the control group, with a statistically significant difference (P<0.001). After treatment, the balance score and daily living ability score of the observation group were lower, while the dizziness score and anxiety and depression score were higher than those of the control group, with statistical significance (P<0.05). The gain value of the horizontal semicircular canal on the affected side after treatment is linearly correlated with the disease course, the start time of rehabilitation treatment, and the pre-treatment dizziness score, with standardized regression coefficients of 0.769, -1.376, and -0.208, respectively. The recovery of the horizontal semicircular canal gain value on the affected side after treatment was used as the dependent variable, and age, disease duration, start time of rehabilitation treatment, and pre-treatment dizziness score were included as independent variables for logistic regression analysis, the results showed that the predictive model had no statistical significance (P>0.05). Conclusion Quantifying the gain value or degree of horizontal semicircular canal damage on the affected side after treatment is insufficient to evaluate the prognosis of AUVP patients. However, whether the gain value of the peripheral horizontal semicircular canals returns to normal or not is related to the clinical prognosis of AUVP patients. AUVP patients whose horizontal semicircular canal function does not return to normal after treatment have a longer disease course, a later start time of rehabilitation treatment, higher anxiety and depression scores, lower balance scores and daily living ability scores, indicating poor prognosis. |
| Key words: vestibular neuritis unilateral vestibulopathy video head impulse test rehabilitation treatment horizontal semicircular canal |