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目的研究肌电图(electromyogram,EMG)修正对前庭诱发肌源性电位(Vestibular-evoked myogenic po-tentials,VEMPs)结果产生的影响,并建立修正后的cervical Vestibular-evoked myogenic potential(c VEMP)及ocularVestibular Evoked Myogenic Potential(o VEMP)正常值范围,为临床上准确评估前庭感受器功能提供更可靠的参考依据。方法采用500Hz tone-burst刺激声对20名(40耳)听力正常且无耳蜗及前庭系统疾病的正常青年人进行c VEMP及o VEMP测试。受试者年龄为20-30岁,平均年龄(23.76±2.81)岁。测试强度为100d B n HL,通过ER-3A标准插入式耳机给声,测试时体位采取坐姿。结果所有受试者均能引出清晰可重复的c VEMP及o VEMP波形。Tone-burst c VEMP的P1潜伏期为14.13±1.97(ms),N1潜伏期为21.54±2.23(ms),幅值为1.63±0.60(μV)。Tone-burst o VEMP的N1潜伏期为10.15±0.72(ms),P1潜伏期为15.79±1.01(ms),幅值为1.38±1.02(μV)。cVEMP修正前后的振幅有显著性差异(*P<0.05),修正前后比值达到40~50倍。结论 EMG修正对振幅标准化有重要意义,其中对c VEMP的测试结果影响较大,建立一组EMG修正后VEMPs的正常参考值范围能够更准确评估双侧不对称性。Tone-burst c VEMP及o VEMP引出率高,可作为临床上评估椭圆囊和球囊功能的常规检测方法。
Objective To investigate the effect of electromyogram (EMG) correction on the results of Vestibular-evoked myogenic po-tentials (VEMPs), and to establish a modified cervical Vestibular-evoked myogenic potential (c VEMP) and ocularVestibular Evoked Myogenic Potential (o VEMP) normal range, to provide a more reliable reference for the accurate assessment of vestibular receptor function in clinic. Methods Twenty young adults (40 ears) with normal hearing and no cochlear and vestibular system diseases were subjected to c VEMP and o VEMP using 500 Hz tone-burst stimuli. Subjects aged 20-30 years, mean age (23.76 ± 2.81) years. The test intensity was 100d B n HL and was acoustically passed through the ER-3A standard plug-in earphones. The posture was taken in sitting position during the test. Results All subjects were able to elicit clear and repeatable c VEMP and o VEMP waveforms. P1 latency of Tone-burst c VEMP was 14.13 ± 1.97 (ms), N1 latency was 21.54 ± 2.23 (ms) and amplitude was 1.63 ± 0.60 (μV). N1 latency of Tone-burst o VEMP was 10.15 ± 0.72 (ms), P1 latency was 15.79 ± 1.01 (ms) and amplitude was 1.38 ± 1.02 (μV). The amplitude of cVEMP before and after correction was significantly different (* P <0.05), before and after the correction ratio reached 40 to 50 times. Conclusions The EMG correction is of great importance to the standardization of amplitude. The test results of c VEMP are greatly influenced. Establishing a normal range of reference values of modified EMG modified VEMPs can evaluate bilateral asymmetry more accurately. Tone-burst c VEMP and o VEMP high extraction rate, can be used as a clinical assessment of oval sac and balloon function of the conventional detection methods.