摘要目的 探讨主观视觉重力线(主观视觉垂直线/水平线,subjective visual vertical/subjective visual horizontal,SVV/SVH)测试在单侧前庭外周性损伤患者前庭代偿评定中的初步应用.方法 69例单侧前庭外周性损伤患者为病例组,分别行SVV/SVH、自发性眼震(spontaneous nystagmus,SN)、冷热试验等前庭功能检测;49名健康人为对照组,完成SVV/SVH测试.以SVV/SVH偏斜角度、SN强度、冷热试验的单侧半规管减退(unilateral weakness,uw)为评定指标,分析SVV/SVH与SN、UW及病程的相关性及其在前庭代偿中的变化特征.结果 病例组SVV、SVH的阳性率分别为60.9％(42/69)和63.8％ (44/69),偏斜角度的绝对值范围分别为2.1°～20.0°和2.1°～22.2°之间.健康对照组SVV、SVH的偏斜角度分别为-1.5°～2.0°和-2.0°～1.6°,与病例组相比,差异具有统计学意义(t值分别为5.336和5.864,P值均＜0.05).病例组SN阳性者28例(40.6％),强度范围在2.4°～17.1°;UW阳性者50例(72.5％).病例组中SVV与SVH之间存在正相关,r =0.948,P=0.000;SVV、SVH分别与SN之间存在负相关,r值分别为-0.720、-0.733,P值均为0.00;SVV、SVH的偏斜角度、SN的强度与UW值之间无相关关系,r值分别为0.191、0.189和0.179,P值均＞0.05.SVV、SVH、SN和UW四项指标的绝对值与病程均无相关关系(rs值分别为-0.075、-0.065、-0.212和0.126,P值均＞0.05).结论 主观视觉重力线不但能够用于评估单侧前庭外周性损伤患者的前庭损伤范围,还可以帮助评定前庭耳石器损伤的静态代偿状态,指导前庭康复.

abstractsObjective To discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal,SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation.Methods 69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH,spontaneous nystagmus (SN),caloric test (CT) and other vestibular function tests.49 healthy people (control group) accepted SVV/SVH only.SVV/SVH,SN and unilateral weakness (UW) were selected as for the observation indicators.The correlations between SVV/SVH,SN,UW and courses were investigated respectively,as well as the characteristic of SVV/SVH,SN in period of vestibular compensation.Results Among case group SVV,SVH positive in 42 patients (60.9％) and 44 patients (63.8％),the absolute values of the skew angle were in the range between 2.1 °-20.0°,2.1 °-22.2°.Skew angles of SVV/SVH in control were in the range between-1.5°-2.0° and-2.0°-1.6°,and had no statistical significance with case group (t =5.336 and 5.864,P ＜ 0.05).SN-positive 28 cases (40.6％),the range of intensities at 2.4°-17.1°;UW-positive 50 cases (72.5％).In case group,positive correlation between SVV and SVH (r =0.948,P =0.00),negatively correlated between SVV/SVH and SN respectively(r values were-0.720,-0.733,P values were 0.00),no correlation between the skew angle of SVV/SVH,strength of SN and UW value(r values were 0.191,0.189,and 0.179,P ＞0.05),there was no correlation between the absolute value of SVV,SVH,SN,UW with the duration (rs values were-0.075,-0.065,-0.212,and 0.126,P ＞ 0.05).Conclusion Subjective visual gravity can be used not only to assess the range of unilateral peripheral vestibular dysfunction,but also help assess the static compensatory of otolithic,guidance and assessment of vestibular rehabilitation.