山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (6): 1-5.doi: 10.6040/j.issn.1673-3770.0.2019.444

• 论著 •    下一篇

前庭性眩晕疾病患者焦虑和抑郁状况研究

蒋黎娜1,于倩如1,于杰1,关本岭2,鹿玉2,于淑东3   

  1. 1. 山东大学, 山东 济南 250100;
    2. 山东中医药大学, 山东 济南 250355;
    3. 山东大学附属山东省立医院 耳鼻喉科, 山东 济南 250021
  • 发布日期:2021-01-11
  • 通讯作者: 于淑东. E-mail:yushudong@126.com

Anxiety and depression in patients with common types of vertigo

JIANG Lina1, YU Qianru1, YU Jie1, GUAN Benling2, LU Yu2, YU Shudong3   

  1. 1. Shandong University, Jinan 250100, Shandong, China;
    2. Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong, China:3. Department of Otolaryngology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Published:2021-01-11

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摘要： 目的 研究临床上常见的四种前庭性眩晕患者的焦虑/抑郁状况及其眩晕残障程度等相关因素并进行分析,为临床诊治四种前庭性眩晕提供依据。 方法 搜集确诊为前庭性眩晕的患者,分别为良性阵发性位置性眩晕(BPPV)、前庭性偏头痛(VM)、梅尼埃病(MD)及前庭神经炎(VN)四种疾病,记录患者的病程、持续时间等一般资料,完善耳科学检查并进行医院焦虑抑郁量表(HAD)、眩晕残障量表(DHI)测定。 结果 纳入前庭性眩晕患者121例,其中BPPV47例,VM31例,MD29例,VN14例,四组患者焦虑/抑郁阳性率分别为BPPV 31.9%、VM 71.0%、MD 75.9%、VN 42.9%;轻度、中度及重度眩晕残障程度分别为BPPV 58.9%、19.8%、21.3%,VM 19.4%、25.8%、54.8%,MD 6.9%、24.1%、69.0%,VN 38.6%、21.4%、40.0%。焦虑与抑郁评分之间线性相关(r=0.570,P<0.05);DHI与HAD评分之间线性相关(r=0.804;P<0.05)。 结论 前庭性眩晕患者存在不同程度的焦虑/抑郁,且焦虑和抑郁有一定的相关性;VM和MD患者焦虑/抑郁的发生率较高;VM、MD及VN患者眩晕残障程度高于BPPV患者。因此在临床上诊治前庭性眩晕疾病的时候要重视患者的焦虑/抑郁状态,特别是VM、MD患者,以便更好的治疗前庭性眩晕。

关键词: 前庭性眩晕, 焦虑, 抑郁, 眩晕残障程度

Abstract: Objective To evaluate anxiety, depression, and disability in patients with vertigo and their underlying factors to provide a basis for clinical diagnosis and treatment of the four common types of vertigo. Methods Patients diagnosed with benign paroxysmal positional vertigo(BPPV), vestibular migraine(VM), Meniere's disease(MD), and vestibular neuritis(VN)were included in the study. Each patient's disease course, duration, relevant general information, and improvements in otological examination findings were evaluated. Anxiety, depression, and disability were also evaluated using the hospital anxiety and depression scale(HAD)and the dizziness disability scale(DHI). Results One hundred and twenty-one patients with vertigo were included; 47 had BPPV, 31 had VM, 29 had MD, and 14 had VN. The positive rates of anxiety and depression among patients with BPPV, VM, MD, and VN were 31.9%, 71.0%, 75.9%, and 42.9%, respectively. The proportions of mild, moderate, and severe cases of vertigo disability were: 58.9%, 19.8%, and 21.3%, respectively, for BPPV; 19.4%, 25.8%, and 54.8%, respectively, for VM; 6.9%, 24.1%, and 69.0% for, respectively, for MD; 38.6%, 21.4%, and 40.0%, respectively, for VN. There was a correlation between anxiety and depression scores(r=0.570, P<0.05)as well as DHI and HAD scores(r=0.804; P<0.05). Conclusion Anxiety and depression were manifested to varying degrees among the vertigo patients, but there was a correlation between them. VM and MD patients had a higher incidence of anxiety and depression, while VM, MD, and VN patients had more severe vertigo and disability than BPPV patients. Therefore, anxiety and depression should be considered during the diagnosis and treatment of vertigo, especially in patients with VM and MD, to facilitate diagnostic accuracy and effective treatment.

Key words: Vestibular vertigo, Anxiety, Depression, Degree of Dizzy disability

中图分类号: 

  • R764
[1] 杨旭. 国内神经科眩晕诊断现况及对策[J]. 中国卒中杂志, 2015(5):373-381. doi:10.3969/j.issn.1673-5765.2015.05.002.
[2] 张清.眩晕患者的情绪分析及心理护理干预[J].中国医药指南,2019,17(8):250-251.doi: 10.15912/j.cnki.gocm.2019.08.210.
[3] Von Brevern M, Bercholon P, Brandt T, et al. Bejnign paroxysmal positional vertigo: diagonostic criteria [J]. Journal of Audiology and Speech Pathology, 2017, 25(5): 450-454. doi:10.3969/j.issn.1006-7299.2017.05.003.
[4] Headache Classification Committee of the International Headache Society(IHS). The International Classification of Headache Disorders[M]. 3rd edition. 2018, 38(1):1-211. [5] Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menière's disease according to the Classification Committee of the Bárány Society[J]. HNO, 2017, 65:887-893. doi:10.1007/s00106-017-0387-z.
[6] 李远军, 徐先荣. 前庭神经炎的研究进展[J]. 中华耳科学杂志, 2016,14(4):515-520. doi:10.3969/j.issn.1672-2922.2016.04.017. LI Yuanjun, XU Xianrong. Advances in diagnosis and treatment of vestibular neuritis [J]. Chinese Journal of Otology, 2016, 14(4):515-520. doi:10.3969/j.issn.1672-2922.2016.04.017.
[7] 杨川, 张素素, 赵菊梅, 等. 医院焦虑抑郁量表在耳鼻咽喉科患者中的应用分析[J]. 中国耳鼻咽喉头颈外科, 2017,24(8):413-416. doi:10.16066/j.1672-7002.2017.08.010. YANG Chuan, ZHANG Susu, ZHAO Jumei, et al. Application of the hospital anxiety and depression scale among the inpatients of otolaryngology [J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(8): 413-416. doi: 10.16066/j.1672-7002.2017.08.010.
[8] 李传硕, 李永团, 曹海南, 等. 眩晕患者的行为类型量化分析[J]. 山东大学耳鼻喉眼学报, 2019,33(5):32-36. doi:10.6040/j.issn.1673-3770.0.2019.030. LI Chuanshuo, LI Yongtuan, CAO Hainan, et al. Quantitative analysis of behavior pattern in vertiginous patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019,33(5): 32-36. doi:10.6040/j.issn.1673-3770.0.2019.030.
[9] 袁庆, 史冬梅, 余力生, 等. 不同周围性眩晕疾病患者焦虑/抑郁状态的比较[J]. 临床耳鼻咽喉头颈外科杂志, 2015,29(8):729-732. doi:10.13201/j.issn.1001-1781.2015.08.016. YUAN Qing, SHI Dongmei, YU Lisheng, et al. Comparison of anxiety and depression state among patients with different type of vestibular peripheral vertigo[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2015, 29(8): 729-732. doi:10.13201/j.issn.1001-1781.2015.08.016.
[10] 吴春芳. 头晕患者的情绪障碍因素分析[J]. 当代医学, 2014,20(33):33. doi:10.3969/j.issn.1009-4393.2014.33.022.
[11] 李非田, 戴春富. 外周性眩晕并发焦虑的神经生物学机制[J]. 中国眼耳鼻喉科杂志, 2018,18(2):134-136,141. doi:10.14166/j.issn.1671-2420.2018.02.018. LI Feitian, DAI Chunfu. Progress in the neurological research on vestibular vertigo combined with anxiety [J]. Chinese Journal of Ophthalmology and otorhinolaryngology, 2018, 18(2): 134-136,141. doi:10.14166/j.issn.1671-2420.2018.02.018.
[12] 陈太生, 王巍, 徐开旭, 等. 良性阵发性位置性眩晕及其诊断治疗的思考[J]. 山东大学耳鼻喉眼学报,2019,33(5):1-5. doi:10.6040/j.issn.1673-3770.1.2019.053. CHEN Taisheng, WANG Wei, XU Kaixu, et al. Thoughts on benign paroxysmal positional vertigo and its diagnosis and treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019,33(5): 1-5. doi:10.6040/j.issn.1673-3770.1.2019.053.
[13] 李晓璐. 前庭性偏头痛与几种常见周围性眩晕的鉴别诊断[J]. 山东大学耳鼻喉眼学报, 2019,33(3):23-26. doi:10.6040/j.issn.1673-3770.1.2019.003. LI Xiaolu. Differential diagnosis of vestibular migraines and several common types of peripheral vertigo [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019,33(3): 23-26. doi:10.6040/j.issn.1673-3770.1.2019.003.
[14] 黄巧, 尹时华. 内耳上皮钠通道、水通道蛋白与内淋巴代谢相关性的研究进展[J]. 山东大学耳鼻喉眼学报, 2019,33(4):145-148. doi:10.6040/j.issn.1673-3770.0.2018.301. HUANG Qiao, YIN Shihua. Correlation between endolymphatic hydrops and inner ear epithelial sodium channels and aquaporins [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019,33(4): 145-148. doi:10.6040/j.issn.1673-3770.0.2018.301.
[15] 张耕, 周婧, 倪长宝, 等. 前庭神经元炎诊治的研究进展[J]. 听力学及言语疾病杂志, 2019,27(6):681-685. doi:10.3969/j.issn.1006-7299.2019.06.024.
[16] 孙振晓, 刘化学, 焦林瑛, 等. 医院焦虑抑郁量表的信度及效度研究[J]. 中华临床医师杂志(电子版), 2017,11(2):198-201. doi:10.3877/cma.j.issn.1674-0785.2017.02.005. SUN Zhenxiao, LIU Huaxue, JIAO Linying, et al. Reliability and validity of hospital anxiety and depression scale [J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(2): 198-201. doi:10.3877/cma.j.issn.1674-0785.2017.02.005.
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