山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 22-25.doi: 10.6040/j.issn.1673-3770.1.2019.041

• 临床研究 • 上一篇    下一篇

良性阵发性位置性眩晕与合并疾病的关联性分析

邓巧媚,张玥琦,王巍,徐开旭,温超,刘强,陈太生(),林鹏   

  1. 天津市第一中心医院耳鼻咽喉头颈外科,天津 300192
  • 收稿日期:2019-06-20 修回日期:2019-07-30 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 陈太生 E-mail:cts501@sina.com

Correlation analysis between benign paroxysmal positional vertigo and associated comorbidities

Qiaomei DENG,Yueqi ZHANG,Wei WANG,Kaixu XU,Chao WEN,Qiang LIU,Taisheng CHEN(),Peng LIN   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin 300192, China
  • Received:2019-06-20 Revised:2019-07-30 Online:2019-09-20 Published:2019-10-15
  • Contact: Taisheng CHEN E-mail:cts501@sina.com

摘要: 目的

探讨良性阵发性位置性眩晕(BPPV)的发病病因及风险因素。

方法

回顾性分析耳鼻喉头颈外科2017年6月至2018年5月的450例BPPV病例的发病情况、明确病因(突聋、头外伤、前庭神经炎、前庭性偏头痛等)及可能的风险因素(高血压、糖尿病、颈椎病、冠心病等相关疾病),并进行分析统计比较。

结果

BPPV患者的平均年龄为(55.52±13.89)岁、男女比例为1:2.21。无合并疾病的患者共有159例,占比35.33%。合并疾病及风险因素的患者共有291例,占比64.67% ,其中明确病因包括突聋、头外伤、前庭神经炎、前庭性偏头痛患者共有78例(17.33%),具有相关疾病患者共有253例(56.22%),其中高血压和糖尿病为最多见的合并疾病,分别占比32.44%和11.56%,但根据二元logistic分析仅有颈椎病与BPPV的发生具有显著的关联性。

结论

64.67%的BPPV的患者具有明确病因及风险因素,多数BPPV患者是继发性BPPV;患者耳石复位后,部分患者病理损伤仍然存在,因此BPPV综合治疗及预防复发还要关注相关疾病和风险因素的干预。

关键词: 眩晕, 良性阵发性位置性眩晕, 病因

Abstract: Objective

To investigate the etiology and risk factors of benign paroxysmal positional vertigo (BPPV).

Methods

We retrospectively analyzed and statistically compared the incidence, etiology, and possible risk factors in 450 cases of BPPV in the Department of Otolaryngology Head and Neck Surgery at our hospital from 2017.

Results

The average age of BPPV patients was 55.52±13.89 years, and the ratio of males to females was 1∶2.21. Of these cases, 159 patients (35.33%) did not have any comorbidities, while 291 patients (64.67%) presented with associated comorbidities. Among them, 78 (17.33%) patients presented with a clear cause such as idiopathic sudden hearing loss, head trauma, vestibular neuritis, or vestibular migraine. A total of 253 (56.22%) patients had associated risk factors such as hypertension, diabetes mellitus, cervical spondylosis, and coronary heart disease. Hypertension and diabetes were the most common comorbidities present in the group, accounting for 32.44% and 11.56%, respectively. However, using binary logistic analysis, only cervical spondylosis appeared to have a significant correlation with the occurrence of BPPV.

Conclusion

About 64.67% of patients presenting with BPPV in this study also had a comorbidity. The majority of patients with BPPV had idiopathic BPPV. After otolith reduction, pathological injury still existed. Treatment of comorbidities should be considered carefully so as to prevent the occurrence and recurrence of BPPV.

Key words: Vertigo, Benign paroxysmal positional vertigo, Cause

中图分类号: 

  • R764.34
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. doi:10.3760/cma.j.issn.1673-0860.2017.03.003 .
doi: 10.3760/cma.j.issn.1673-0860.2017.03.003
Editorial Board Of Chinese Journal Of Otorhinolary . Guideline of diagnosis and treatment of benign paroxysmal positional vertigo (2017)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(3): 173-177. doi:10.3760/cma.j.issn.1673-0860.2017.03.003 .
doi: 10.3760/cma.j.issn.1673-0860.2017.03.003
2 Bhattacharyya N , Gubbels SP , Schwartz SR , et al . Clinical practice guideline: benign paroxysmal positional vertigo (update)[J]. Otolaryngol Head Neck Surg, 2017, 156(3_suppl)S1-S47. doi:10.1177/0194599816689667 .
doi: 10.1177/0194599816689667
3 De Stefano A , Dispenza F , Suarez H , et al . A multicenter observational study on the role of comorbidities in the recurrent episodes of benign paroxysmal positional vertigo[J]. Auris Nasus Larynx, 2014, 41(1): 31-36. doi:10.1016/j.anl.2013.07.007 .
doi: 10.1016/j.anl.2013.07.007
4 Dispenza F , De Stefano A , Mathur N , et al . Benign paroxysmal positional vertigo following whiplash injury: a myth or a reality?[J]. Am J Otolaryngol, 2011, 32(5): 376-380. doi:10.1016/j.amjoto.2010.07.009 .
doi: 10.1016/j.amjoto.2010.07.009
5 张云美, 杨振栋, 李万鑫, 等 . 绝经女性良性阵发性位置性眩晕的复发与骨密度及雌激素水平的关系[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(12): 881-884. doi:10.3760/cma.j.issn.1673-0860.2017.12.001 .
doi: 10.3760/cma.j.issn.1673-0860.2017.12.001
ZHANG Yunmei , YANG Zhendong , LI Wanxin , et al . The relationship between the recurrence of benign paroxysmal positional vertigo and the level of bone mineral as well as estrogen in postmenopausal women[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(12): 881-884. doi:10.3760/cma.j.issn.1673-0860.2017.12.001 .
doi: 10.3760/cma.j.issn.1673-0860.2017.12.001
6 张娜, 陈太生, 董红, 等 . 良性阵发性位置性眩晕病因学分析[J]. 临床耳鼻咽喉头颈外科杂志, 2011, 25(7): 307-311. doi:10.3969/j.issn.1001-1781.2011.07.007 .
doi: 10.3969/j.issn.1001-1781.2011.07.007
ZHANG Na , CHEN Taisheng , DONG Hong , et al . To analyze the etiology of benign paroxysmal positional vertigo[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2011, 25(7): 307-311. doi:10.3969/j.issn.1001-1781.2011.07.007 .
doi: 10.3969/j.issn.1001-1781.2011.07.007
7 薛海龙, 李仓霞, 段立欣, 等 . 军事训练伤后良性发作性位置性眩晕24例诊治分析[J]. 人民军医, 2017, 60(1): 16-17.
8 El-Saied S , Joshua BZ , Segal N , et al . Sudden hearing loss with simultaneous posterior semicircular canal BPPV: possible etiology and clinical implications[J]. Am J Otolaryngol, 2014, 35(2): 180-185. doi:10.1016/j.amjoto.2013.08.021 .
doi: 10.1016/j.amjoto.2013.08.021
9 Kim YH , Kim KS , Kim KJ , et al . Recurrence of vertigo in patients with vestibular neuritis[J]. Acta Otolaryngol, 2011, 131(11): 1172-1177. doi:10.3109/00016489 .2011.593551.
doi: 10.3109/00016489
10 Balatsouras DG , Koukoutsis G , Ganelis P , et al . Benign paroxysmal positional vertigo secondary to vestibular neuritis[J]. Eur Arch Otorhinolaryngol, 2014, 271(5): 919-924. doi:10.1007/s00405-013-2484-2 .
doi: 10.1007/s00405-013-2484-2
11 Chu CH , Liu CJ , Lin LY , et al . Migraine is associated with an increased risk for benign paroxysmal positional vertigo: a nationwide population-based study[J]. J Headache Pain, 2015, 16: 62. doi:10.1186/s10194-015-0547-z .
doi: 10.1186/s10194-015-0547-z
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