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目的通过观察突发性聋伴眩晕患者前庭诱发肌源性电位的引出率及各参数,探讨前庭诱发肌源性电位对突聋伴眩晕患者内耳损伤情况的诊断及预后评估。方法收集50例单耳突聋伴眩晕的患者,50例单耳突聋不伴眩晕患者及60例正常听力人作为对照组,分析对比o VEMP及c VEMP的引出率和各参数变化。结果引出率:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组o VEMP引出率分别为24%、42%、48%、100%,c VEMP引出率分别为:56%、74%、64%、100%,病例组患耳和对侧耳相比,o VEMP及c VEMP引出率差异无统计学意义(P>0.05),病例组患耳及对侧耳分别和正常对照组比较,o VEMP及c VEMP引出率均明显降低(P<0.05),病例组患耳o VEMP引出率明显低于突聋不伴眩晕组(P<0.05)。o VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数(N1潜伏期、P1潜伏期、P1-N1振幅)两两比较,组间不对称比(AR)比较,差异均无统计学意义(P均>0.05)。c VEMP:病例组患耳、对侧耳、突聋不伴眩晕组及正常对照组的各参数比较,患耳及对侧耳P1-N1振幅比突聋不伴眩晕组及正常对照组均明显降低(P<0.05),病例组AR比正常对照组明显增高(P<0.05),o VEMP及c VEMP结果与听力损失分型、听力损失程度分级无明显相关性(P>0.05),但与疗效分级明显相关(P<0.05)。结论突聋伴眩晕患者存在同侧及对侧的椭圆囊(前庭上神经)和球囊(前庭下神经)传导功能障碍,前庭诱发肌源性电位为突聋伴眩晕患者耳石器及前庭神经功能评估提供客观依据。
OBJECTIVE: To evaluate the diagnosis and prognosis of the inner ear injury in patients with sudden deafness and vertigo by observing the rate of myogenic evoked potential and the parameters of vestibular evoked potential in patients with sudden deafness and vertigo. Methods Fifty patients with mononeuric deafness and vertigo were included in this study. Fifty patients with unilateral auricular deafness and vertigo without hearing loss and 60 normal hearing persons were enrolled in this study. The changes of lead ratio and parameters of VEMP and c VEMP were analyzed. The results showed that the lead rate of VEMP was 24%, 42%, 48% and 100% respectively in the affected ears, contralateral ear, sudden deafness without vertigo group and normal control group. The c VEMP lead-out rates were 56% 74%, 64%, 100% respectively. There was no significant difference in the extraction rates of o VEMP and c VEMP between the ear and the contralateral ear in the case group (P> 0.05). Compared with the normal control group, (P <0.05). The lead rate of VEMP was lower in case group than that in sudden deafness without vertigo group (P <0.05). o VEMP: comparison of parameters (N1 latency, P1 latency, P1-N1 amplitude) in each group of ears, contralateral ear, sudden deafness without vertigo and normal control group, comparison of asymmetry between groups There was no significant difference (P> 0.05). c VEMP: Compared with the parameters of the affected ear, contralateral ear, sudden deafness without vertigo group and normal control group, the amplitude of P1-N1 in the affected ears and contralateral ears was significantly lower than that of sudden deafness without vertigo group and normal control group (P <0.05). The AR of the cases was significantly higher than that of the normal control group (P0.05). There was no significant correlation between the results of VEMP and c VEMP and the classification of hearing loss and grade of hearing loss (P0.05) Significantly related (P <0.05). Conclusions The patients with sudden deafness and dizziness have the ipsilateral and contralateral oval capsule (vestibular nerve) and the balloon (vestibular nerve) conduction dysfunction. The vestibular evoked myogenic potential is the otolith and vestibular nerve function in patients with sudden deafness and vertigo Evaluation provides an objective basis.