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目的:探讨单温试验筛选价值及评估前庭功能的可靠性。方法:1406例眩晕患者分2组进行冷热试验,先冷后热组705例,先热后冷组701例。2组的先冷和先热刺激分别作为单冷、单热试验,计算单温试验单侧前庭反应减退及冷热试验、眼震优势偏向(DP),以冷热试验结果为对照标准,计算单温试验的灵敏度、特异度、正确诊断指数和Kappa值等。结果:先冷后热组:冷热和单冷试验均阳性428例,均阴性145例,单独阳性分别为85例、47例,单冷试验灵敏度为83.4%,特异度为75.5%,正确诊断指数为0.589,Kappa值为0.555(P<0.01)。先热后冷组:冷热和单热试验均阳性429例,均阴性130例,单独阳性分别为82例、60例,单热试验灵敏度为84.0%,特异度为68.4%,正确诊断指数为0.524,Kappa值为0.505(P<0.01)。排除伴有自发性眼震(SN)患者,单冷和单热试验的灵敏度分别为86.9%、86.9%;排除含有DP患者,单冷和单热试验的灵敏度分别为89.3%、88.1%。结论:DP、SN等多种因素影响单温试验结果,单温试验的假阳性率、假阴性率均较高,不宜常规作为冷热试验的筛选试验。
Objective: To investigate the screening value of single-temperature test and evaluate the reliability of vestibular function. Methods: 1406 cases of vertigo patients were divided into 2 groups, hot and cold test, 705 cases of cold after the first heat group, 701 cases of the first warm after the cold group. Two groups of pre-cooling and first thermal stimulation were used as single-cold and single-heat test, respectively, to calculate single-chamber test unilateral vestibular reaction decreased and cold test, nystagmus bias (DP), the cold test results as a control standard, calculated Single-temperature test sensitivity, specificity, correct diagnostic index and Kappa value. Results: After the first cold-hot group, 428 cases were positive and negative, respectively, 145 cases were negative and 85 cases were positive alone, 47 cases were single cold test, the sensitivity was 83.4% and the specificity was 75.5% The index was 0.589 and the Kappa value was 0.555 (P <0.01). The first hot aftercooling group: Both hot and cold test were positive in 429 cases, all were negative in 130 cases, respectively, 82 cases were positive alone, 60 cases, the single thermal test sensitivity was 84.0%, specificity was 68.4%, the correct diagnostic index 0.524, Kappa value of 0.505 (P <0.01). Excluding those with spontaneous nystagmus (SN), the single-cold and single-heat tests showed sensitivities of 86.9% and 86.9%, respectively. The sensitivity of single-cold and single-heat tests excluding DP patients was 89.3% and 88.1%, respectively. Conclusion: DP, SN and other factors affect the single-temperature test results, single-temperature test false positive rate, false negative rate are high, not routine as a hot and cold test screening test.