Otolithic Membrane

耳膜
  • 文章类型: Journal Article
    化石鱼耳石(耳石)中保存的有机物的氮同位素是重建过去环境变化的有希望的工具。我们分析了白垩纪晚期鱼耳石(Eutawichthysmaastrerhtiensis,Eutawichthyszideki和Pterorothissussp.)来自美国东海岸的三个矿床,两个坎帕尼亚(83.6至77.9Ma)和一个马斯特里赫特(72.1至66Ma)年龄。δ15N和N含量对清洁方案和耳石形态特征的保存状态不敏感,分类群之间的氮含量差异在沉积物中是一致的,指向有机物质的化石原生起源。从坎帕尼亚到马斯特里赫蒂,这三个物种的耳石结合有机质δ15N都增加了约4‰。至于其原因,不同属的相似变化与营养水平的变化相反,和现代现场数据反对沉积矿床的不同位置。相反,坎帕尼亚州较低的δ15N最好解释为区域尺度或更大的环境信号,这可能是全球气候变暖的结果。在新生代的温暖时期,有孔虫结合的δ15N也出现了类似的下降,反映了水柱反硝化作用的降低,从而在温暖条件下海洋缺氧区(ODZs)的收缩。白垩纪耳石中相同的δ15N-气候相关性提出了ODZ-气候关系的前景,该关系在过去的〜80My中一直是一致的,在白垩纪末期大灭绝之前和之后以及大陆构型的跨越变化中应用。
    The nitrogen isotopes of the organic matter preserved in fossil fish otoliths (ear stones) are a promising tool for reconstructing past environmental changes. We analyzed the 15N/14N ratio (δ15N) of fossil otolith-bound organic matter in Late Cretaceous fish otoliths (of Eutawichthys maastrichtiensis, Eutawichthys zideki and Pterothrissus sp.) from three deposits along the US east coast, with two of Campanian (83.6 to 77.9 Ma) and one Maastrichtian (72.1 to 66 Ma) age. δ15N and N content were insensitive to cleaning protocol and the preservation state of otolith morphological features, and N content differences among taxa were consistent across deposits, pointing to a fossil-native origin for the organic matter. All three species showed an increase in otolith-bound organic matter δ15N of ~4‰ from Campanian to Maastrichtian. As to its cause, the similar change in distinct genera argues against changing trophic level, and modern field data argue against the different locations of the sedimentary deposits. Rather, the lower δ15N in the Campanian is best interpreted as an environmental signal at the regional scale or greater, and it may be a consequence of the warmer global climate. A similar decrease has been observed in foraminifera-bound δ15N during warm periods of the Cenozoic, reflecting decreased water column denitrification and thus contraction of the ocean\'s oxygen deficient zones (ODZs) under warm conditions. The same δ15N-climate correlation in Cretaceous otoliths raises the prospect of an ODZ-to-climate relationship that has been consistent over the last ~80 My, applying before and after the end-Cretaceous mass extinction and spanning changes in continental configuration.
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  • 文章类型: Dataset
    本文介绍了来自339个红鱼(Mullusbarbatus)的3D矢状左耳石网格数据集。这些未成熟的标本是从覆盖整个地中海的17个地理区域收集的。测得的生物学参数为:鱼的总长度(TL±1mm,范围从125到238毫米),总重量(W±0.1g,范围从14.9到168.0克),sex(S),性成熟分期(垫)。3D耳石数据集包括使用显微层析成像获得的高分辨率耳石网格(29.2μπι体素尺寸)。这些数据为地中海红鱼种群的形态变异性和种群结构提供了宝贵的见解。数据集的潜在应用包括年龄确定,库存识别,和人口连通性分析。这些应用旨在增进对红乌鱼种群的了解,并为地中海海洋资源的可持续管理做出贡献。
    This paper presents a dataset of 3D sagittal left otolith meshes from 339 individual red mullet (Mullus barbatus). These immature specimens were collected from 17 geographical areas covering the entire Mediterranean Sea. Measured biological parameters were: fish total length (TL ± 1 mm, range from 125 to 238 mm), total weight (W ± 0.1 g, range from 14.9 to 168.0 g), sex (S), sexual maturity staging (Mat). The 3D otolith dataset comprises high-resolution meshes of otoliths obtained using microtomography (29.2 μm voxel size). The data offer valuable insights into the morphological variability and population structure of red mullet populations in the Mediterranean Sea. Potential applications of the dataset include age determination, stock identification, and population connectivity analysis. These applications aim to enhance the understanding of red mullet populations and contribute to the sustainable management of marine resources in the Mediterranean Sea.
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  • 文章类型: Journal Article
    波罗的海的人为脱氧导致底栖和底栖栖息地质量大幅下降,从而影响生物多样性和生态系统服务。使用波罗的海鳕鱼耳石化学代理缺氧,盐度,鱼类的代谢状态和生长,我们追踪了新石器时代晚期(4500BP)和20世纪早期到现在的基线条件的变化,为了了解最近,加速的气候变化影响了这个关键物种。耳石缺氧代理(Mn:Mg)随着缺氧水量的增加而增加,但随着耳石Sr:Ca的盐度增加而降低。耳石Mg:Ca和重建的生长所代表的代谢状态与溶解氧饱和度呈正相关,自2010年以来特别严重的下降。耳石指标的长期记录提供了进一步的证据,表明氧气的状态发生了深远的变化,在世界上最大的内陆海之一。由于气候变暖而导致的缺氧扩散可能会损害全球鱼类种群,并且可以通过耳石化学生物标志物来追踪证据。
    Anthropogenic deoxygenation of the Baltic Sea caused major declines in demersal and benthic habitat quality with consequent impacts on biodiversity and ecosystem services. Using Baltic cod otolith chemical proxies of hypoxia, salinity, and fish metabolic status and growth, we tracked changes from baseline conditions in the late Neolithic (4500 BP) and early twentieth century to the present, in order to understand how recent, accelerating climate change has affected this key species. Otolith hypoxia proxies (Mn:Mg) increased with expanding anoxic water volumes, but decreased with increasing salinity indexed by otolith Sr:Ca. Metabolic status proxied by otolith Mg:Ca and reconstructed growth were positively related to dissolved oxygen percent saturation, with particularly severe declines since 2010. This long-term record of otolith indicators provides further evidence of a profound state change in oxygen for the worse, in one of the world\'s largest inland seas. Spreading hypoxia due to climate warming will likely impair fish populations globally and evidence can be tracked with otolith chemical biomarkers.
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  • 文章类型: Journal Article
    海洋变暖将继续影响生长,海洋鱼类的身体状况和地理分布以及了解这些影响是渔业研究和管理的紧迫挑战。确定如何记录鱼耳石碳酸盐中的温度,提供了一个额外的按时间顺序排列的工具来调查热历史,个人生活史中的偏好和运动模式。三种水温处理的影响(22°C,25°C,和28°C)在孵化场饲养的幼年粗壮的白色上,西拉戈·罗布斯塔,使用受控的户外中观系统进行了测试。测量鱼的长度和重量的变化,并使用生物电阻抗分析确定身体状况。通过同位素比质谱法分析矢状耳石的稳定氧(δ18Ootolith)和碳(δ13Cotolith)同位素。与25°C和28°C的鱼类相比,在22°C下保持的白色鱼明显较小,并且身体状况有所下降,彼此之间没有显着差异。粗壮白垩的δ18O耳石值显示出负的温度依赖性分馏关系,其斜率相似,但截距与无机文石和其他海洋鱼类报道的关系不同。δ13C耳石值也与水温呈负相关,在最冷(22°C)和最热(28°C)温度处理下饲养的鱼之间,耳石中代谢碳M的计算比例有所不同。总的来说,结果表明,粗壮白鲸可能已经达到25°C至28°C之间的生长上限阈值,在温暖的季节和分布的偏北地区,生长和身体状况可能会得到优化。耳石氧气测温显示出有望成为热生命史的自然示踪剂,在可能的情况下,应使用特定物种的分馏方程,以防止野生捕获鱼的温度重建错误。
    Ocean warming will continue to affect the growth, body condition and geographic distributions of marine fishes and understanding these effects is an urgent challenge for fisheries research and management. Determining how temperature is recorded in fish otolith carbonate, provides an additional chronological tool to investigate thermal histories, preferences and patterns of movement throughout an individual\'s life history. The influence of three water temperature treatments (22°C, 25°C, and 28°C) on hatchery-reared juvenile stout whiting, Sillago robusta, was tested using a controlled outdoor mesocosm system. Fish were measured for change in length and weight, and body condition was determined using bioelectrical impedance analysis. Sagittal otoliths were analysed for stable oxygen (δ18Ootolith) and carbon (δ13Cotolith) isotopes via isotope ratio mass spectrometry. Whiting kept at 22°C were significantly smaller and had diminished body condition compared to fish in 25°C and 28°C, which did not significantly differ from each other. The δ18O otolith values of stout whiting demonstrated a negative temperature-dependent fractionation relationship which was similar in slope but had a different intercept to the relationships reported for inorganic aragonite and other marine fish species. The δ13C otolith values also showed a negative relationship with water temperature, and the calculated proportion of metabolic carbon M in otoliths differed between fish reared in the coolest (22°C) and warmest (28°C) temperature treatments. Overall, the results suggest that stout whiting may have reached an upper growth threshold between 25°C and 28°C, and that growth and body condition may be optimised during warmer seasons and toward the northerly regions of their distribution. Otolith oxygen thermometry shows promise as a natural tracer of thermal life history, and species-specific fractionation equations should be utilised when possible to prevent errors in temperature reconstructions of wild-caught fish.
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  • 文章类型: Journal Article
    机体代谢异常可通过对耳石膜的结构及耳石正常生理代谢过程产生一定的影响,进而作用于良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的发生、发展和预后。本文就代谢异常与BPPV相关的基础研究和临床研究做一总结,探究代谢异常在BPPV中的影响。.
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  • 文章类型: Journal Article
    目的:评估单侧后管良性阵发性位置性眩晕(BPPV)成功进行耳石复位手术(CRP)后残留头晕患者的耳石功能,并调查可能的危险因素。
    方法:本病例对照观察性研究包括健康对照和BPPVCRP改善后残留头晕的患者。所有参与者都接受了完整的历史记录,耳镜检查,听力学基础评价,Dix-Hallpike测试以搜索后管BPPV,残留头晕筛查,前庭诱发肌源性电位(VEMP)测试。评估了组间差异,并通过单变量分析确定了与残留头晕相关的可能因素。
    结果:共有50例残留头晕患者(平均年龄,56.53±7.46岁[29名女性:21名男性])和50名健康对照(平均年龄,包括58.13±7.57岁[20名女性:30名男性])。在患者组和对照组之间发现VEMP潜伏期的显着差异(在患者组中延迟),两耳振幅无明显组间差异。衰老,女性性别,BPPV持续时间长,CRP数量,颈部VEMP和眼部VEMP异常,冬季发病,与残余头晕的风险显著相关。
    结论:残余头晕是BPPV的常见后遗症,可能与耳石功能障碍有关。VEMP变化以延迟延迟的形式显示。
    OBJECTIVE: To evaluate otolithic functions in patients with residual dizziness after successful canalith repositioning procedures (CRPs) for unilateral posterior canal benign paroxysmal positional vertigo (BPPV), and to investigate possible risk factors.
    METHODS: This case-control observational study included healthy controls and patients with residual dizziness after improvement following CRP for BPPV. All participants were subjected to full history taking, otoscopy, audiological basic evaluation, Dix-Hallpike test to search for posterior canal BPPV, residual dizziness screening, and vestibular evoked myogenic potential (VEMP) testing. Between-group differences were assessed and possible factors associated with residual dizziness were identified by univariate analysis.
    RESULTS: A total of 50 patients with residual dizziness (mean age, 56.53 ± 7.46 years [29 female: 21 male]) and 50 healthy controls (mean age, 58.13 ± 7.57 years [20 female: 30 male]) were included. A significant difference in VEMP latencies was found between the patient and control group (delayed in the patient group), with no significant between-group difference in amplitude in both ears. Aging, female sex, long duration of BPPV, number of CRPs, cervical VEMP and ocular VEMP abnormalities, and winter onset, were significantly associated with the risk of residual dizziness.
    CONCLUSIONS: Residual dizziness is a frequent sequel of BPPV that may relate to otolithic dysfunction. VEMP changes were revealed in the form of delayed latencies.
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  • 文章类型: Journal Article
    在这项研究中,我们研究了两种鱼类的生长动力学和耳石形状不对称性,黑毛虫(CN)和尼罗罗非鱼(ON),在南部泻湖系统的城市化流域内,尼日利亚。使用vonBertalanffy生长模型(VBGM),除了沉积物金属浓度指数,如平均页岩含量,地质累积指数(Igeo),污染因子(CF),污染负荷指数(PLI),和潜在生态风险(PER)指数,污染水平被分类,并对生态风险进行了评估。值得注意的是,在Ikorodu观察到CN的生长潜力(t0)低于Epe,在旱季期间,Epe中的ON趋势相似。耳石不对称模式,特别是在旱季伊科罗杜的CN和Epe的ON,表现出明显的生态变化,表明伊科罗杜的压力水平升高。沉积物分析显示中度至强污染(Cd,Pb,Ni,和Cr)在拉各斯泻湖(Ikorodu)和Epe泻湖中,根据CF指数,Ikorodu表现出明显的高到中等污染水平。Ikorodu中Cd和Pb的PLI值升高,除了更大的PER,表明风险增加,Cd风险较高(61.42%),Pb风险中等(49.50%)。此外,旱季期间Epe的渐近长度减少表明,NigrodigitatusChrysichthys可适应季节性变化,而这两个领域不同的增长模式表明,在不断变化的条件下,存在权衡机制。栖息地特有的耳石不对称性和金属污染强调了物种的适应性,拉各斯的压力源变异性比Epe大。此外,多维尺度分析强调了耳石形状变量与环境因素之间的复杂关系,强调需要对城市化流域进行量身定制的保护工作。
    In this study, we investigated the growth dynamics and otolith shape asymmetry of two fish species, Chrysichthys nigrodigitatus (CN) and Oreochromis niloticus (ON), within urbanized watersheds of the southern lagoon system, Nigeria. Using the von Bertalanffy growth model (VBGM), in addition to sediment metal concentration indices such as the average shale content, index of geoaccumulation (Igeo), contamination factor (CF), pollution load index (PLI), and potential ecological risk (PER) index, contamination levels were classified, and ecological risks were assessed. Notably, a lower growth potential (t0) was observed in CN at Ikorodu than at Epe, with similar trends for ON in the Epe during the dry season. Otolith asymmetry patterns, particularly in the CN at Ikorodu and ON in the Epe during the dry season, exhibited distinct ecological variations, indicating heightened stress levels at Ikorodu. Sediment analyses revealed moderate to strong contamination (Cd, Pb, Ni, and Cr) in both Lagos Lagoon (Ikorodu) and Epe Lagoon, with Ikorodu exhibiting notably high to moderate contamination levels according to the CF index. Elevated PLI values for Cd and Pb in Ikorodu, in addition to greater PER, indicated increased risk, with Cd posing a high risk (61.42%) and Pb posing a moderate risk (49.50%). Additionally, the reduced asymptotic length in the Epe during the dry season suggests that Chrysichthys nigrodigitatus is adaptable to seasonal variations, while divergent growth patterns in both areas indicate the existence of trade-off mechanisms in response to changing conditions. Habitat-specific otolith asymmetry and metal contamination underscore species adaptability, with wider stressor variability in Lagos than in Epe. Furthermore, multidimensional scaling analysis highlights the intricate relationship between otolith shape variables and environmental factors, emphasizing the need for tailored conservation efforts in urbanized watersheds.
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  • 文章类型: Journal Article
    海洋酸化可以改变海水中微量元素的生物有效性和化学性质,这可能会影响它们融入海洋生物的钙质结构。鱼耳石,文石制成的生物矿化耳石,悬浮在硬骨鱼的内淋巴液中,这表明耳石的元素掺入也可能容易受到海洋酸化的影响。在这项研究中,我们评估了CO2引起的海洋酸化(pH8.10、7.70和7.30,对应于政府间气候变化专门委员会预测的代表性浓度路径8.5模型下的海洋酸化情景)和水元素浓度锶(Sr)和钡(Ba;低,中等,和高)在早期生命阶段将元素掺入比目鱼的耳石中。我们的结果表明,Sr和Ba元素掺入耳石主要取决于相应的水元素浓度,而不是海洋酸化。此外,随着水元素浓度的增加,Sr和Ba的分配系数(DMe)在达到动态平衡后可能会稳定。但不受海洋酸化的影响。因此,在生命早期阶段将Sr和Ba掺入比目鱼的耳石中可能不能有效地指示海洋酸化。换句话说,研究结果表明,在追踪比目鱼的温度或盐度经历时,海洋酸化不会影响Sr和Ba掺入到耳石中。我们的发现将为了解海洋酸化对鱼类招募动态的潜在生态影响提供新的知识。
    Ocean acidification could modify the bioavailability and chemical properties of trace elements in seawater, which could affect their incorporation into the calcareous structures of marine organisms. Fish otoliths, biomineralized ear stones made by aragonite, are suspended within the endolymph fluid of teleosts, indicating that the elemental incorporation of otoliths might also be susceptible to ocean acidification. In this study, we evaluated the combined effects of CO2-induced ocean acidification (pH 8.10, 7.70, and 7.30, corresponding to ocean acidification scenarios under the representative concentration pathway 8.5 model as projected by the Intergovernmental Panel on Climate Change) and water elemental concentrations of strontium (Sr) and barium (Ba; low, medium, and high) on elemental incorporation into otoliths of the flounder Paralichthys olivaceus at early life stages. Our results revealed that the elemental incorporation of Sr and Ba into otoliths was principally dependent on the corresponding water elemental concentrations rather than on ocean acidification. Moreover, the partition coefficients (DMe) of Sr and Ba may stabilize after dynamic equilibrium is reached as the water elemental concentration increases, but are not affected by ocean acidification. Therefore, the incorporation of Sr and Ba into otoliths of the flounder at early life stages may not serve as an effective indicator of ocean acidification. In other words, the findings suggest that ocean acidification does not impact the incorporation of Sr and Ba incorporation into otoliths when tracing the temperature or salinity experiences of the flounder. Our findings will provide new knowledge for understanding the potential ecological effects of ocean acidification on the recruitment dynamics of fish species.
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  • 文章类型: English Abstract
    Objective: To investigate the altered function of the semicircular canal and otolith graviceptive pathway in patients diagnosed with motion sickness disorder (MSD) based on the diagnostic criteria of the Bárány society, and explore its relevance to the pathogenesis of MSD. Methods: This is a case-control study. Twenty patients with MSD and age-and sex-matched healthy controls without a history of MSD from the Department of Neurology of Aerospace Center Hospital between March and August 2022 were recruited. All subjects completed the motion sickness susceptibility questionnaire-short version (MSSQ-short) and the motion sickness assessment questionnaire (MSAQ). Canal function was evaluated using caloric stimulation test and video head impulse test (vHIT), and subjective visual vertical/horizontal (SVV/SVH) and vestibular evoked myogenic potential (VEMP) were employed to assess otolith graviceptive function. Differences in vestibular function and correlations between the two groups were analyzed. Results: Each group consisted of 20 cases (9 males and 11 females). The mean age of the MSD and control groups was (26.9±3.9) years and (27.0±3.4) years, respectively. The scores of MSSQ-short [27.0 (22.5, 38.8) vs 1.2 (0, 3.2), P<0.001] and MSAQ [70.1 (54.5, 78.1) vs 11.8 (11.1, 13.9), P<0.001] were significantly higher in the MSD group compared with those of the control group. Evaluation of canal function revealed a significantly higher incidence of caloric stimulation intolerance in MSD patients (60.0%, 12/20) compared with that of the control group (20.0%, 4/20) (P=0.010). Evaluation of otolith graviceptive pathway indicated no significant difference in SVV, SVH and cervical VEMP (cVEMP) abnormality rates between the two groups (all P>0.05). The ocular VEMP (oVEMP) abnormality rate was significantly higher in the MSD group (55.0%, 11/20) than that of the control group (10.0%, 2/20) (P=0.002), with a delayed P1-wave latency compared with the control group [(18.4±1.2) ms vs (17.6±0.8) ms, P=0.018]. Further correlation analysis revealed that P1-wave latency in oVEMP was positively correlated with MSSQ-short (r=0.486, P=0.002) and MSAQ (r=0.391, P=0.015) scores, and duration of caloric intolerance symptoms (r=0.377, P=0.004). Conclusion: The presence of hypersensitivity to caloric stimulation and delayed latency of otolith function in patients with MSD suggests a \"separation\" between semicircular canal and otolithic function, which may be related to sensory conflict.
    目的: 探讨基于Bárány协会诊断标准纳入的运动病(MSD)患者半规管与耳石重力通路功能改变及可能的发病机制。 方法: 病例对照研究。纳入2022年3至8月招募的20例MSD患者(MSD组)及20名性别、年龄相匹配,无MSD病史的健康对照(对照组),在航天中心医院完成研究。所有受试者均完成运动不耐受易感性问卷简版(MSSQ-short)、运动不耐受评估问卷(MSAQ),完善基于半规管功能的双温试验、视频头脉冲试验(vHIT)和耳石重力通路功能的主观视觉垂直/水平(SVV/SVH)、前庭诱发肌源性电位(VEMP)的功能评价,分析MSD患者前庭功能改变情况,并进一步探讨MSD可能的发病机制。 结果: 每组20例受试者中,男9例,女11例;MSD组年龄(26.9±3.9)岁,对照组年龄(27.0±3.4)岁。MSD组MSSQ-short得分[27.0(22.5,38.8)分比1.2(0,3.2)分,P<0.001]和MSAQ得分[70.1(54.5,78.1)分比11.8(11.1,13.9)分,P<0.001]均高于对照组。半规管功能评价结果显示,MSD患者双温试验不耐受的发生率(60.0%,12/20)高于对照组(20.0%,4/20)(P=0.010)。耳石重力通路评价结果显示,SVV、SVH、颈性VEMP(cVEMP)异常率两组差异均无统计学意义(均P>0.05)。MSD组眼性VEMP(oVEMP)异常率(55.0%,11/20)高于对照组(10.0%,2/20)(P=0.002),其中P1波潜伏期较对照组延迟[(18.4±1.2)ms比(17.6±0.8)ms,P=0.018]。相关性分析结果显示,oVEMP的P1波潜伏期与MSSQ-short(r=0.486,P=0.002)、MSAQ(r=0.391,P=0.015)得分及双温不耐受症状持续时间(r=0.377,P=0.004)均呈正相关。 结论: MSD患者存在半规管刺激的高敏及耳石器潜伏期延迟受损,提示半规管和耳石器功能“分离”现象,可能参与MSD感觉冲突的发生。.
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  • 文章类型: Randomized Controlled Trial
    Objective: To compare the clinical efficacy of personalized vestibular rehabilitation and otolith reposition in treating atypical benign paroxysmal positional vertigo (BPPV). Methods: A randomized controlled trial was carried out. Fifty patients diagnosed with atypical BPPV in the Vertigo Clinic of the First Affiliated Hospital of Shandong First Medical University from October 2022 to September 2023 were recruited and randomly divided into manual reduction group (25 cases) and vestibular rehabilitation group (25 cases) according to the random number table. All patients were given flunarizine. Patients in the manual reduction group were treated by Epley maneuver and (or) Barbecue maneuver, while the vestibular rehabilitation group was given personalized vestibular rehabilitation therapy. After two weeks\' treatment, the clinical symptoms (positional vertigo/nystagmus) and total dizziness handicap inventory (DHI) score, DHI physical (DHI-P), DHI emotional (DHI-E), and DHI functional (DHI-F) of the two groups were evaluated and compared. Results: A total of 50 patients diagnosed with atypical BPPV were included, including 23 males and 27 females, with an average age of (48.8±14.5) years. There was no statistically significant difference between the two groups in age, gender, disease severity, Romberg, position test abnormality ratio (Dix-hallpike/Roll test), temperature test, and video head impulse test baseline test results (all P>0.05). After 2 weeks of treatment, the effective rates of the treatment in the manual reduction and vestibular rehabilitation groups were 56.0% (14/25) and 88.0% (22/25), respectively, with a statistically significant difference (P=0.025). The total DHI score, DHI-P, DHI-E, and DHI-F scores in both groups were significantly decreased after treatment (all P<0.001). Compared with the manual reduction group, the total DHI score (23.2±2.7 vs 36.4±15.7, P=0.002), DHI-P (10.2±4.6 vs 13.7±5.3, P=0.016) and DHI-F (6.5±6.4 vs 13.0±7.2, P=0.002) in the vestibular group were lower, however, there was no significant difference in DHI-E score between the two groups (6.6±4.8 vs 9.6±7.3, P=0.087). Conclusion: Compared with otolith reposition, personalized vestibular rehabilitation therapy plays a better role in improving the symptoms and decreasing DHI score for patients with atypical BPPV.
    目的: 比较个性化前庭康复和耳石复位对不典型良性阵发性位置性眩晕(BPPV)的疗效。 方法: 随机对照试验。纳入2022年10月至2023年9月就诊于山东第一医科大学第一附属医院眩晕门诊的50例不典型BPPV患者,根据随机数字表法分为耳石复位组(25例)和前庭康复组(25例)。在常规口服用药基础上,耳石复位组根据症状和体征分别给予Epley和(或)Barbecue复位法,前庭康复组则予以制定个性化前庭康复方案进行治疗。于治疗后2周进行随访,对两组患者的临床疗效、眩晕残障量表(DHI)总分及躯体(DHI-P)、情感(DHI-E)、功能(DHI-F)三个维度评分进行比较。 结果: 50例不典型BPPV患者中,男23例,女27例,年龄(48.8±14.5)岁。耳石复位组和前庭康复组患者年龄、性别、DHI评分、Romberg试验分级、位置试验异常比例、双温试验异常比例、视频头脉冲试验(vHIT)基线结果比较差异均无统计学意义(均P>0.05)。治疗2周后耳石复位组、前庭康复组的眩晕治疗有效率分别为56.0%(14/25)和88.0%(22/25),差异有统计学意义(P=0.025)。两组患者治疗后DHI总分及DHI-P、DHI-E、DHI-F三个维度评分均较治疗前改善,差异均有统计学意义(均P<0.001)。与耳石复位组比较,前庭康复组患者治疗2周后DHI总分[(23.2±2.7)分比(36.4±15.7)分,P=0.002]以及DHI-P[(10.2±4.6)分比(13.7±5.3)分,P=0.016]、DHI-F[(6.5±6.4)分比(13.0±7.2)分,P=0.002]评分均更低,但DHI-E评分两组差异无统计学意义[(6.6±4.8)分比(9.6±7.3)分,P=0.087]。 结论: 个性化前庭康复治疗可以改善不典型BPPV的眩晕残障程度,且临床疗效优于耳石复位治疗。.
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