Research progress on the questionnaire related to persistent postural-perceptual dizziness
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摘要: 持续性姿势-知觉性头晕(persistent postural-perceptual dizziness，PPPD)是最常见的慢性前庭疾病，其临床表现为持续3个月以上的头晕、不稳和非旋转性眩晕，并因直立姿势、主动或被动运动和复杂视觉刺激而加重。PPPD属于功能性疾病，故常规前庭功能检查及影像学检查往往呈阴性。根据Bárány协会制定的诊断标准，PPPD诊断依靠病史。本文就PPPD相关问卷展开综述。
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关键词:
- 持续性姿势-知觉性头晕 /
- 问卷 /
- 慢性前庭疾病
Abstract: Persistent postural-perceptual dizziness(PPPD) is the most common chronic vestibular disease, the clinical manifestation is dizziness, unstable and non-rotational dizziness for three months or more. And the symptom is exacerbated by upright posture, active or passive movement, and complex visual stimuli. In addition, PPPD is a functional disease, so routine vestibular function tests and imaging tests are often negative. According to the diagnostic criteria established by the Barany Association, the diagnosis of PPPD often relies on history. This article provides a review of PPPD-related questionnaires. -
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表 1 PPPD相关量表的优缺点
优点 缺点 DSP 1.操作简单，用于快速筛查分诊
2.能动态反映疾病的发展转归
3.可诊断共病
4.包括三大核心前庭症状
5.评估患者情绪问题(抑郁和焦虑)
6.评估直立姿势1.不专门针对PPPD的临床诊断
2.不包括病程持续时间
3.不包括其他加重因素
4.不包括触发事件
5.不包括疾病带来的严重痛苦和功能障碍NPQ 1.评估PPPD患者的疾病严重程度
2.用于对比治疗前后的变化
3.全面评估PPPD的三大加重因素，条目较SITQ和VVAS全面1.不包括核心前庭症状和持续时间
2.不包括触发事件
3.不包括疾病带来的影响
4.不能评估情绪问题SITQ 1.评估主动或被动运动方面：条目较多，比较同一因素的细微差别
2.询问症状是否具有晨轻暮重的特点1.完成问卷的时间长，门诊应用不便
2.未评估直立姿势
3.在评估视觉刺激方面，条目设置单一VVAS 1.条目精简，便于临床使用
2.全部是日常生活会出现的情境
3.较SITQ更适合评估症状在治疗前后的细微改善。1.不包括直立姿势，全面评估加重因素受到限制
2.不能诊断PPPDDHI 1.评估患者的心理状态
2.量化PPPD患者治疗前后的变化
3.评估疾病带给患者的影响1.用于首诊或随访的PPPD患者
2.并非基于一个被广泛接受的标准化分类而设计
3.评估加重因素的条目不全面VAP 1.评估慢性头晕患者活动受限程度
2.量化PPPD患者治疗前后的改善
3.是第1个使用ICF来评估前庭研究和临床实践中的活动和参与结果的工具1.用于首诊或随访的PPPD患者
2.不包括情绪评估的条目
3.仅纳入主动或被动运动的条目，没有其他加重因素的题项共同的缺点 1.不包括核心前庭症状和持续时间；2.不包括触发事件；3.评估加重因素的条目不全面(除NPQ外)；4.不包括慢性头晕对患者身体功能和社交行为的影响(除DHI、VAP)；5.不能排除其他疾病 
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