Analysis of clinical characteristics and risk factors in patients with benign paroxysmal positional vertigo
-
摘要: 目的 分析良性阵发性位置性眩晕(BPPV)患者的临床特征, 探讨与BPPV发病有关的危险因素, 为减少BPPV的危险因素暴露、进行早期干预提供参考。方法 将112例BPPV患者纳入研究, 分析年龄、性别、发作症状和持续时间、既往病史和家族史等临床资料; 采用卡方检验对患者的年龄、性别、糖尿病、高尿酸、高血脂、骨质疏松、高血压、冠心病、脑卒中、梅尼埃病、化脓性中耳炎、前庭神经元炎、突发性聋、颅脑外伤、耳鼻/颌面部手术、自身免疫性甲状腺炎共16个变量进行单因素方差分析; 将单因素方差分析有统计学意义的参数纳入多因素回归分析。结果 BPPV患者中76例(67.86%)为原发性, 36例(32.14%)为继发性(P < 0.01);两组BPPV患者的性别构成(男、女)、患耳(单侧、双侧)、累及半规管(后半规管型、水平半规管型、前半规管型、混合型)的差异有统计学意义(均P < 0.05)。随访期内34例(30.36%)复发, 其中原发性19例(25.00%), 继发性15例(41.67%), 原发性BPPV患者的复发率低于继发性(P < 0.01)。糖尿病(P=0.004)、骨质疏松(P=0.017)、高血压(P=0.013)、脑卒中(P=0.005)和化脓性中耳炎(P=0.031)与BPPV的发病相关。结论 BPPV患者以原发性为主, 而继发性患者更容易复发。糖尿病、骨质疏松、高血压、脑卒中和化脓性中耳炎是BPPV发病的独立危险因素。Abstract: Objective To analyze the clinical characteristics of patients with benign paroxysmal positional vertigo, summarize experience for diagnosis and treatment activities and to explore the risk factors related to the onset of BPPV and provide reference for early intervention to reduce the risk factor exposure of BPPV.Methods One hundred and twelve patients with BPPV were included in the study, and clinical data including age, gender, onset symptoms and duration, past medical history and family history were analyzed. A One-way ANOVA was performed on 16 variables using age, gender, diabetes, hyperuric acid, hyperlipidemia, osteoporosis, hypertension, coronary heart disease, stroke, Meniere's disease, suppurative otitis media, vestibular neuronitis, sudden deafness, head injury, ear nose/maxillofacial surgery and autoimmune thyroiditis. The statistically significant parameters of the one-way ANOVA were included in the multivariate regression analysis to explore the independent risk factors for BPPV.Results Seventy-six cases(67.86%) of BPPV patients were primary BPPV, 36 cases(32.14%) were secondary BPPV(P < 0.01). The gender composition(male, female), ears involvement(unilateral, bilateral) and semicircular canal involvement(posterior semicircular canal, horizontal semicircular canal, anterior semicircular canal, mixed type) were different between the two groups(P < 0.05). During the follow-up period, 34(30.36%) patients relapsed, of which 19(25.00%) were the primary patients and 15(41.67%) were the secondary patients(P < 0.01). Diabetes(P=0.004), osteoporosis(P=0.017), hypertension(P=0.013), stroke(P=0.005) and suppurative otitis media(P=0.031) were related to the onset of BPPV.Conclusion BPPV patients are mainly primary, while the secondary patients are more likely to relapse after being cured. Diabetes, osteoporosis, hypertension, stroke and suppurative otitis media are independent risk factors for the onset of BPPV.
-
Key words:
- vertigo /
- clinical features /
- risk factors /
- regression analysis
-
-
表 1 单因素分析
例(%) 因素 例数 BPPV组 对照组 χ2 P 性别 男 118 49(41.53) 69(58.47) 4.382 < 0.05 女 114 63(55.26) 51(44.74) 糖尿病 有 81 51(62.96) 30(37.04) 11.034 < 0.01 无 151 61(40.40) 90(59.60) 高尿酸 有 46 29(63.04) 17(36.96) 5.011 < 0.05 无 186 83(44.62) 103(55.38) 高血脂 有 78 47(60.26) 31(39.74) 6.754 < 0.01 无 154 65(42.21) 89(57.79) 骨质疏松 有 54 33(61.11) 21(38.89) 4.644 < 0.05 无 178 79(44.38) 99(55.62) 高血压 有 89 58(65.17) 31(34.83) 20.199 < 0.01 无 143 54(37.76) 89(62.24) 脑卒中 有 17 13(76.47) 4(23.53) 5.84 < 0.05 无 215 99(46.05) 116(53.95) 梅尼埃病 有 24 20(83.33) 4(16.67) 13.176 < 0.01 无 208 92(44.23) 116(55.77) 化脓性中耳炎 有 47 29(61.70) 18(38.30) 4.255 < 0.05 无 185 83(44.86) 102(55.14) 前庭神经元炎 有 31 24(77.42) 7(22.58) 12.171 < 0.01 无 201 88(43.78) 113(56.22) 
下载: 导出CSV
表 2 多因素Logistic回归分析
组别 回归系数(β值) 标准误 Wals值 P OR 95%CI 糖尿病 1.162 0.538 6.137 0.004 3.589 1.714~15.842 骨质疏松 0.123 0.342 4.335 0.017 4.300 0.438~6.225 高血压 1.531 0.479 6.364 0.013 5.006 1.736~13.536 脑卒中 1.479 0.475 8.251 0.005 4.518 1.266~11.334 化脓性中耳炎 1.515 0.696 4.769 0.031 4.372 1.270~14.674
下载: 导出CSV
-
[1] Yazıcı A, İnanç Y. Evaluation of BPPV with vertebral artery values[J]. Neuropsychiatr Dis Treat, 2018, 14: 1975-1979. doi: 10.2147/NDT.S169991
[2] Shih CP, Wang CH, Chung CH, et al. Increased Risk of Benign Paroxysmal Positional Vertigo in Patients With Non-Apnea Sleep Disorders: A Nationwide, Population-Based Cohort Study[J]. J Clin Sleep Med, 2018, 14(12): 2021-2029. doi: 10.5664/jcsm.7528
[3] Tang H, Li W. Advances in the diagnosis and treatment of benign paroxysmal positional vertigo[J]. Exp Ther Med, 2017, 14(3): 2424-2430. doi: 10.3892/etm.2017.4837
[4] 陈敏, 胡兴越. 良性阵发性位置性眩晕[J]. 国际神经病学神经外科学杂志, 2019, 33(4): 315-318. https://www.cnki.com.cn/Article/CJFDTOTAL-GWSK200604006.htm
[5] 王会, 于栋祯. 持续性向地性变向性位置性眼震: 一种独立的疾病实体?[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(12): 950-953. doi: 10.3760/cma.j.issn.1673-0860.2018.12.016
[6] 刘教练. 良性阵发性位置性眩晕临床听力及前庭功能检测结果分析[J]. 医学临床研究, 2018, 35(10): 2003-2005. doi: 10.3969/j.issn.1671-7171.2018.10.047
[7] 崔程敏, 闫亚平, 张淑香. 原发性和继发性良性阵发性位置性眩晕临床特征分析[J]. 北京医学, 2018, 40(8): 742-744. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX201808007.htm
[8] 李潇潇, 区永康, 唐小武, 等. 良性阵发性位置性眩晕复发的临床特征分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(11): 823-826. https://www.cnki.com.cn/Article/CJFDTOTAL-LCEH201811007.htm
[9] Cui C, Yan Y, Zhang S, et al. Clinical characteristics of primary and secondary benign paroxysmal positional vertigo[J]. Beijing Med J, 2018, 40(8): 742-744.
[10] Zhao A, Liu B, Zhang Y, et al. Study of Pure Tone Audiometry in Patients with Benign Paroxysmal Positional Vertigo[J]. J Audiol Speech Pathol, 2018, 6(4): 1006-7299.
[11] 朱晓东, 司马国旗, 戴利菊, 等. 老年人良性阵发性位置性眩晕与血尿酸的关系[J]. 中国耳鼻咽喉头颈外科, 2016, 23(12): 696-699. https://www.cnki.com.cn/Article/CJFDTOTAL-EBYT201612006.htm
[12] Wang Z, Yao G, Tao X, et al. Calcium Metabolism in Recurrent Benign Paroxysmal Positional Vertigo in Middle Aged and older Women[J]. Chin J Otol, 2019, 6(10): 1672-2922.
[13] Melis A, Rizzo D, Gallus R, et al. Relationship between calcium metabolism and benign paroxysmal positional vertigo in north Sardinia population[J]. J Vestib Res, 2020, 30(6): 375-382. doi: 10.3233/VES-200025
[14] Chen J, Zhang S, Cui K, et al. Risk factors for benign paroxysmal positional vertigo recurrence: a systematic review and meta-analysis[J]. J Neurol, 2020.
[15] Yamanaka T, Shirota S, Sawai Y, et al. Osteoporosis as a risk factor for the recurrence of benign paroxysmal positional vertigo[J]. Laryngoscope, 2013, 123(11): 2813-2816. doi: 10.1002/lary.24099
[16] Yu S, Liu F, Cheng Z, et al. Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review[J]. BMC Neurol, 2014, 14: 110. doi: 10.1186/1471-2377-14-110
[17] Messina A, Casani AP, Manfrin M, et al. Italian survey on benign paroxysmal positional vertigo[J]. Acta Otorhinolaryngol Ital, 2017, 37(4): 328-335. doi: 10.14639/0392-100X-1121
[18] Tan J, Deng Y, Zhang T, et al. Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension[J]. Acta Otolaryngol, 2017, 137(5): 482-484. doi: 10.1080/00016489.2016.1247985
-