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目的探讨前庭自旋试验(vestibular autorotation text,VAT)、经颅多谱勒超声(TCD)在中枢性眩晕诊断中的临床应用价值。方法对86例中枢性眩晕患者和对照组(周围性眩晕患者68例、健康志愿者36例)进行VAT和TCD检测,计算检查两种方法完成率和敏感性等指标;比较中枢性眩晕组和对照组VAT、TCD参数水平的差异。结果190例研究对象TCD完成率(100%)高于VAT完成率91.6%(P<0.05);中枢性眩晕组、周围性眩晕组、健康对照组VAT完成率分别为93%、88.2%、94.4%(P>0.05)。完成2个检测方法的174例研究对象,中枢性眩晕组水平增益增高高于其他组(P<0.05);周围性眩晕水平增益降低高于其他组(P<0.05);周围性眩晕组中非对称性异常高于其他组(P<0.05);三组间的水平相移、垂直相移、垂直增益无明显差异(P>0.05);VAT法对中枢性眩晕的敏感性、特异性、阳性拟然比、阴性拟然比分别为85%、94.7%、12.41、0.16;TCD法分别为52.5%、89.4%、2.73、0.53;2种方法联合为92.5%、86.2%、6.19、0.09。结论 VAT和TCD对诊断中枢性眩晕的价值各有优劣,VAT比TCD更灵敏、准确,而TCD法更简便,检查完成率更高,2种方法联合时诊断的敏感性增加,提高了中枢性眩晕的诊断水平。
Objective To investigate the clinical value of vestibular autorotation text (VAT) and transcranial Doppler sonography (TCD) in the diagnosis of central vertigo. Methods 86 patients with central vertigo and control group (68 patients with peripheral vertigo and 36 healthy volunteers) were examined by VAT and TCD. The completion rates and sensitivities of the two methods were calculated and compared. Central vertigo group and The differences of VAT and TCD parameters in the control group. Results TCD completion rate (100%) was higher than that of VAT completion rate (91.6%) in 190 subjects (P <0.05). VAT completion rates in central vertigo group, peripheral vertigo group and healthy control group were 93%, 88.2%, 94.4 % (P> 0.05). The 174 subjects who completed 2 test methods had higher level gain in the central vertigo group than those in the other groups (P <0.05), and those in the peripheral vertigo group were significantly lower than those in the other groups (P <0.05) There was no significant difference in horizontal phase shift, vertical phase shift and vertical gain between the three groups (P> 0.05). The sensitivity, specificity and positive rate of VAT on central vertigo The quasi-ratio, negative quasi-ratio were 85%, 94.7%, 12.41, 0.16 respectively; TCD method was 52.5%, 89.4%, 2.73, 0.53 respectively; The combination of the two methods was 92.5%, 86.2%, 6.19,0.09. Conclusions The value of VAT and TCD in diagnosis of central vertigo have their own advantages and disadvantages. VAT is more sensitive and accurate than TCD, while TCD method is more convenient and has a higher examination completion rate. The diagnostic sensitivity of both methods increases, Sexual dizziness diagnosis level.