中华耳科学杂志2026，Vol.24Issue(4)：289-296,8.DOI:10.3969/j.issn.1672-2922.2026.04.001
前庭神经炎患者半规管高频功能恢复状况与临床疗效的多因素回归分析
Multifactorial regression analysis of semicircular canal high-frequency function recovery and clinical efficacy in patients with vestibular neuritis
摘要
Abstract
Objective To report on the predictive value of the video head impulse test(vHIT)for the recovery of semicircular canal high-frequency function in patients with vestibular neuritis(VN).Methods A total of 147 VN patients admitted to the Department of Otolaryngology at Haidian Hospital in Beijing from September 2019 to March 2024 were divided into a good-recovery(81 cases)and a poor recovery group(66 cases)base on the level of semicircular canal high-frequency function recovery.Their clinical data and vHIT test indicators were compared.The receiver operating characteristic(ROC)curve was used to determine the predictive value of each indicator for semicircular canal high-frequency function recovery.Multivariate logistic regression analysis was employed to identify independent factors affecting semicircular canal high-frequency function recovery.The differentiating ability of the logistic regression model was assessed using ROC curves,the predictive accuracy was evaluated by constructing a calibration curve,and decision curve analysis was used to measure the clinical utility of the model.Internal validation of the model was conducted using the enhanced Bootstrap method to comprehensively evaluate the overall performance of the model.Results The number of cases with cervical spondylosis,migraine,stroke and sleep disorders in the poor recovery group was higher than in the good recovery group(P<0.05),while the vestibular-ocular reflex(VOR)gain values in the poor recovery group were lower than those in the good recovery group.The number of patients with saccadic waves and the rate of abnormal vHIT in cases with positive gain asymmetry were higher in the poor recovery group than in the good recovery group(P<0.05).Various vHIT indicators showed certain guiding values in predicting the recovery of semicircular canal high-frequency function after treatment(P<0.05),with the VOR gain value demonstrating relatively high accuracy(P<0.05),and the combination of all indicators showing the highest accuracy in identifying poor recovery(P<0.05).Multivariate logistic regression results showed that migraine,stroke,VOR gain value and VOR gain asymmetry ratio were independent predictors of semicircular canal high-frequency function recovery.Conclusions Migraine,stroke,VOR gain values and VOR gain asymmetry ratio are independent factors predicting semicircular canal high-frequency function recovery.A combined model based on these indicators can effectively predict recovery and provide important references for clinical interventions.关键词
前庭神经炎/视频头脉冲试验/半规管高频功能Key words
vestibular neuritis/video-head impulse test/semicircular canal high-frequency function引用本文复制引用
严森,李征玥,陈平,吴文..前庭神经炎患者半规管高频功能恢复状况与临床疗效的多因素回归分析[J].中华耳科学杂志,2026,24(4):289-296,8.基金项目
北京市海淀医院2020年院级科研基金项目(KYQ2020028) （KYQ2020028）
