特发性良性阵发性位置性眩晕患者的骨代谢研究

张祎; 刘博; 田晓波; 毕竞韬

doi:10.13201/j.issn.1001-1781.2019.03.013

特发性良性阵发性位置性眩晕患者的骨代谢研究

- 1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(北京, 100730);
- 2. 首都医科大学附属北京同仁医院检验科(北京, 100730)
基金项目:
北京市科委健康培育项目 (No:Z151100003915100)

首都卫生科研发展专项 (No:首发2016-3-1091)

北京同仁医院院内基金 (No:TRYY-KYJJ-2016-024)

详细信息

通讯作者: 刘博,E-mail:trliubo@139.com

中图分类号: R764.3

收稿日期: 2018-12-20

An analysis of biochemical markers of bone metabolism in patients with idiopathic benign paroxysmal positional vertigo

- 1. Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, 100730, China;
- 2. Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University

More Information

Corresponding author: LIU Bo, E-mail: trliubo@139.com

Received Date: 20 December 2018

摘要

摘要: 目的:探讨特发性良性阵发性位置性眩晕(iBPPV)患者的骨代谢特点及与BPPV的关系。方法:研究纳入确诊的iBPPV患者38例(病例组),对照组32例为同期无头晕病史的健康体检志愿者。病例组与对照组进行骨代谢生化标志物检测,包括骨钙素(OC)、25羟维生素D3[25(OH) D3]、总1型前胶原氨基末端肽(PINP)、B胶原降解产物(β-CTx)。并根据年龄分为<50岁组和≥50岁组,进行数据分析。结果:①病例组中,右后半规管管石症23例,左后半规管管石症9例,右侧水平半规管管石症2例,左侧水平半规管管石症2例,右侧水平半规管嵴帽结石症2例。②病例组骨代谢血清学检查:OC为(15.99±5.00) ng/ml、25(OH) D3为(15.78±6.82) ng/ml、PINP为(46.61±14.95) ng/ml、β-CTx为(0.381±0.189) ng/ml,OC与25(OH) D3值均低于正常值范围。病例组的OC (t=-2.013,P=0.048)、25(OH) D3(t=-2.133,P=0.037)和PINP (t=-2.615,P=0.011)均低于对照组,且差异有统计学意义;β-CTx虽然低于对照组,但差异无统计学意义(P>0.05)。③年龄<50岁组的OC (t=-2.187,P=0.035)、25(OH) D3(t=-2.190,P=0.035)和PINP (t=-2.322,P=0.026)均低于对照组,差异有统计学意义;年龄≥50岁组患者各项标志物均与对照组差异无统计学意义(P>0.05)。结论:iBPPV可能与骨代谢异常相关,在年龄<50岁患者中更为显著。
- 眩晕 /
- 骨代谢 /
- 生化标志物
Abstract: Objective:To analyze the biochemical markers of bone metabolism in patients with idiopathic benign paroxysmal positional vertigo (iBPPV).Method:The study included 38 patients with iBPPV.Thirty-two healthy persons were collected as control group.Routine history collection, physical examination, and diagnosis were recorded in case group.Both the case group and control group were assessed for the status of bone biochemical markers.Result:①Among the 38 patients with iBPPV, posterior semicircular canal BPPV in right ear (R-PC-BPPV) presented in 23 cases, left ear (L-PC-BPPV) in 9 cases, horizontal semicircular canal BPPV in right ear in 2 cases, and in left ear in 2 cases, horizontal semicircular canal cupulolithiasis in 2 cases.②The value of osteocalcin (OC), 25 hydroxyvitamin D3[25 (OH) D3], amino terminal propeptide of type I procollagen (PINP) in case group were lower than the normal reference value, and also significantly lower than that in the control group, OC:t=-2.013, P=0.048;25 (OH) D3:t=-2.133, P=0.037;PINP:t=-2.615, P=0.011.There was no significant difference ofβ-isomerized carboxy-terminal telopeptide of type I collagen (β-CTx) between the case group and control group.③The value of OC (t=-2.187, P=0.035), 25 (OH) D3 (t=-2.190, P=0.035) and PINP (t=-2.322, P=0.026) in patients lower than 50 years old were significantly lower than that in the control group.The difference of these biochemical markers between the case and control group was not significant when subjects were ≥ 50 years old.Conclusion:The biochemical markers of bone metabolism in patients with iBPPV are declined, especially in patients lower than 50 years old.There may be abnormal bone metabolism in iBPPV patients.
- vertigo /
- bone metabolism /
- biochemical markers of bone metabolism

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参考文献(27)

[1]	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会.良性阵发性位置性眩晕诊断和治疗指南 (2017)[J].中华耳鼻咽喉头颈外科杂志, 2017, 52 (3):173-177.
[2]	VON BREVERN M, BERTHOLON P, BRANDT T, et al.Benign paroxysmal positional vertigo:Diagnostic criteria[J].J Vestib Res, 2015, 25:105-117.
[3]	VON BREVERN M, RADTKE A, LEZIUS F, et al.Epidemiology of benign paroxysmal positional vertigo:apopulation based study[J].J Neurol Neurosurg Psychiatry, 2007, 78:710-715.
[4]	张祎, 刘博, 左丽静, 等.良性阵发性位置性眩晕临床特点[J].中国耳鼻咽喉头颈外科, 2010, 17 (12):646-649.
[5]	ICHIJO H, AKITA M.Gender difference and laterality of sleep position[J].Auris Nasus Larynx, 2018, 45:592-597.
[6]	CAKIR B O, ERCAN I, CAKIR Z A, et al.What is the true incidence of horizontal semicircular canal benign paroxysmal positional vertigo[J]?Otolaryngol Head Neck Surg, 2006, 134:451-454.
[7]	LUNDERG Y W, XU Y, THIESSEN K D, et al.Mechanisms of otoconia and otolith development[J].Dev Dyn, 2015, 244:239-253.
[8]	WANGEMANN P.Supporting sensory transduction:cochlear fluid homeostasis and the endocochlear potential[J].J Physiol, 2006, 576:11-21.
[9]	ROSS M D, WILLIAMS T J.Otoconial complexes as ion reservoirs in endolymph[J].Physiologist, 1979, 22:S63-S64.
[10]	TAKUMIDA M, ZHANG D M, YAJIN K.In vitro calcium ion turnover in otoconia of the guinea pig[J].Auris Nasus Larynx, 1997, 24:119-124.
[11]	JANG Y S, HWANG C H, SHIN J Y, et al.Age-related changes on the morphology of the otoconia[J].Laryngoscope, 2006, 116:996-1001.
[12]	VIBERT D, KOMPIS M, HAUSLER R.Benign paroxysmal positional vertigo in older women may be related to osteoporosis and osteopenia[J].Ann Otol Rhinol Laryngol, 2003, 112:885-889.
[13]	JEONG S H, CHOI S H, KIM J Y, et al.Osteopenia and osteoporosis in idiopathic benign positional vertigo[J].Neurology, 2009, 72:1069-1076.
[14]	翟秀云, 刘博, 张玉和, 等.良性阵发性位置性眩晕患者的骨密度研究与分析[J].临床耳鼻咽喉头颈外科杂志, 2016, 30 (23):1865-1869, 1872.
[15]	魏雅楠, 苗懿德, 刘忠厚, 等.骨代谢生化标志物的临床进展-不同国家和地区绝经前后女性骨代谢标志物参考值回顾分析[J].中国骨质疏松杂志, 2007, 13 (7):455-468.
[16]	BROWN J P, DELMAS P D, MALAVAL L, et al.Serum bone Gla-protein:a specific marker for bone formation in postmenopausal osteoporosis[J].Lancet, 1984, 1:1091-1093.
[17]	刘红, 廖二元, 伍贤平, 等.正常女性与年龄相关的骨转化生化指标和骨密度的关系[J].中华内科杂志, 2004, 43 (11):805-809.
[18]	中华医学会骨质疏松和骨矿盐疾病分会.骨代谢生化标志物临床应用指南[J].中华骨质疏松和骨矿盐疾病杂志, 2015, 8 (4):283-293.
[19]	YAN L, PRENTICE A, ZHANG H, et al.Vitamin Dstatus and parathyroid hormone concentrations in Chinese women and men from north-east of the People's Republic of China[J].Eur J Clin Nurt, 2000, 54:68-72.
[20]	JEONG S H, KIM J S, SHIN J W, et al.Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo[J].J Neurol, 2013, 260:832-838.
[21]	ALGARNI M A, MIRZA A A, ALTHOBAITI A A, et al.Association of benign paroxysmal positional vertigo with vitamin D deficiency:a systematic review and meta-analysis[J].Eur Arch Otorhinolaryngol, 2018, 275:2705-2711.
[22]	KAHRAMAN S S, OZCAN O, ARLI C, et al.Calcium Homeostasis During Attack and Remission in Patients With Idiopathic Benign Paroxysmal Positional Vertigo[J].Otol Neurotol, 2016, 37:1388-1392.
[23]	PARHAM K, LEONARD G, FEINN R S, et al.Prospective clinical investigation of the relationship between idiopathic benign paroxysmal positional vertigo and bone turnover:apilot study[J].Laryngoscope, 2013, 123:2834-2839.
[24]	LEE S B, LEE C H, KIM Y J, et al.Biochemical markers of bone turnover in benign paroxysmal positional vertigo[J].PLoS One, 2017, 12:e0176011.
[25]	WU Y, FAN Z, JIN H, et al.Assessment of Bone Metabolism in Male Patients With Benign Paroxysmal Positional Vertigo[J].Front Neurol, 2018, 9:742.
[26]	艾桂萍, 唐志毅, 高德芹, 等.216例老年男性骨代谢生化指标调查结果分析[J].中华老年医学杂志, 1999, 18 (1):19-20.
[27]	张新伟, 李金奎, 汤海燕, 等.健康人群骨代谢标志物分析[J].临床血液学杂志, 2018, 31 (10):794-796.