绝经后良性阵发性位置性眩晕患者血清性激素及25-羟胆钙化醇水平变化研究  

The study of changes of serum sex hormones and 25-(OH)-D_3 levels in postmenopausal patients with benign proxysmal positional vertigo

作　　者：顾欢欢 李斐 张照环 杨月嫦 高博 尚辰勇 庄建华 李焰生(点评)[2] GU Huan-huan;LI Fei;ZHANG Zhao-huan;YANG Yue-chang;GAO Bo;SHANG Chen-yong;ZHUANG Jian-hua(Department of Neurology,Shanghai Changzheng Hospital of Navy Medical University)

机构地区：[1]海军军医大学附属长征医院神经内科海军军医大学眩晕专病诊治中心,上海200003 [2]上海交通大学医学院附属仁济医院南院神经科

出　　处：《中国现代神经疾病杂志》2019年第1期27-32,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：上海市科学技术委员会科研计划项目(项目编号:18ZR1439200)~~

摘　　要：目的探讨女性绝经后血清性激素和25-羟胆钙化醇[25-(OH)-D_3]表达变化与良性阵发性位置性眩晕(BPPV)之间的关系。方法选择2015年9月1日至2017年2月1日共63例50～80岁绝经后女性良性阵发性位置性眩晕患者,采用电化学发光法检测血清雌二醇、黄体酮、黄体生成素、促卵泡激素和25-(OH)-D_3水平,采用Spearman秩相关分析年龄与雌二醇、雌二醇与25-(OH)-D_3之间的关联性;采用单因素和多因素逐步法Logistic回归分析筛查疾病危险因素。结果 BPPV组患者血清雌二醇[15.67(10.96,22.15)pg/ml]和25-(OH)-D_3[(24.24±1.05)ng/ml]水平均低于对照组[雌二醇:31.78(25.60,39.50)pg/ml,25-(OH)-D_3:(27.62±0.76)ng/ml],且组间差异具有统计学意义(Z=-6.768,P=0.000;t=-2.605,P=0.010),而黄体酮、黄体生成素、促卵泡激素组间差异无统计学意义。相关分析显示,两组受试者血清雌二醇与25-(OH)-D_3水平无关联性;但对照组年龄与血清雌二醇水平呈负相关(rs=-0.263,P=0.038),BPPV组二者则无关联性。多因素逐步法Logistic回归分析显示,绝经后女性血清雌二醇和25-(OH)-D_3水平降低是良性阵发性位置性眩晕的危险因素。结论血清雌二醇和25-(OH)-D_3水平降低可能是女性绝经后罹患良性阵发性位置性眩晕的危险因素。Objective To explore the change of serum sex hormones and 25-hydroxycholecalciferol[25-(OH)-D3] level in postmenopausal female patients with benign paroxysmal positional vertigo(BPPV).Methods Electrochemiluminescence(ECL) assay was employed to detect the serum levels of estradiol(E2),progesterone, luteinizing hormone(LH), follicle stimulating hormone(FSH), and 25-(OH)-D3 in 63 femalepostmenopausal BPPV patients with age 50-80 years from September 1, 2015 to February 1, 2017.Spearman rank correlation analysis was used to analyze the relation between age and E2, E2 and 25-(OH)-D3.Univariate and multivariate stepwise Logistic regression analysis were used to screen the risk factors forBPPV. Results The serum levels of E2[15.67(10.96, 22.15) pg/ml] and 25-(OH)-D3[(24.24 ± 1.05) ng/ml]in BPPV group were lower than those in control group [E2: 31.78(25.60, 39.50) pg/ml, 25-(OH)-D3:(27.62 ±0.76) ng/ml], and the differences were statistically significant(Z =-6.768, P = 0.000;t =-2.605, P = 0.010).There was no significant difference on progesterone, LH and FSH between 2 groups. Correlation analysisshowed there was no relation between E2 and 25-(OH)-D3 levels in both groups. There was a negativecorrelation between age and E2 in control group(rs=-0.263, P = 0.038), but no correlation in BPPV group.Multivariate Logistic regression analysis showed decreased serum E2 and 25-(OH)-D3 levels maybe the riskfactors for postmenopausal female BPPV patients. Conclusions E2 and 25-(OH)-D3 deficiency are independent risk factors for BPPV in postmenopausal female patients.

关 键 词：眩晕 耳石膜 骨化二醇 性腺甾类激素 回归分析 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]