良性阵发性位置性眩晕与血清尿酸关系的研究  

Relationship between serum level of uric acid and benign paroxysmal positional vertigo

作　　者：袁俊亮[1] 陈以丽 陈宇丹[1] 牛世芹[1] 李淑娟[1] 董谦[1] 胡文立[1] 

机构地区：[1]首都医科大学附属北京朝阳医院神经内科,100020 [2]云南大理州人民医院神经内科

出　　处：《中华医学杂志》2015年第5期344-348,共5页National Medical Journal of China

基　　金：国家自然科学基金（81301016,81271309）;北京自然科学基金（7122067）

摘　　要：目的 探讨基于中国人群的血清尿酸（UA）水平和良性阵发性位置性眩晕（BPPV）之间的关系.方法 收集来自于2013年7月至2014年7月首都医科大学附属北京朝阳医院神经内科病房因眩晕入院的患者,包括87例BPPV患者,36名年龄、性别相匹配的健康对照组,BPPV组进行完整的体位试验,包括测试后半规管的Dix-Hallpike试验和测试水平半规管的仰卧位转头试验.采集心脑血管病相关的危险因素（如高血压、糖尿病、冠心病、高脂血症、吸烟饮酒史等）、血常规和血液生化分析.结果 与健康对照组相比,BPPV患者在性别、年龄、既往心脑血管病危险因素、收缩压、舒张压、心脏射血分数、血脂水平、同型半胱氨酸、前白蛋白、血常规、尿素氮上差异无统计学意义（P＞0.05）.在尿酸[（267±86） μmol/L比（325±75） μmol/L]、糖化血红蛋白[（5.6± 1.4）％比（6.5±1.0）％]、白蛋白[（36±4）g/L比（40±4）g/L]、肌酐[（72±20） μmol/L比（81 ±22） μmol/L]四个指标上差异具有统计学意义,BPPV组显著低于健康对照组（P＜0.05）.多因素Logistic回归模型分析发现,低糖化血红蛋白水平、低白蛋白血症是BPPV发生的独立预测因子,OR（95％ CI）分别是1.473（1.066 ～2.037） （P ＜0.05）、1.162（1.025 ～1.318） （P ＜0.05）,并没有发现UA是BPPV发生的独立预测因子[OR=1.005（1.000 ～ 1.011）,P=0.063].结论 本研究虽然发现BPPV患者存在血清UA的显著降低,然而没有得出UA水平是BPPV发生的独立危险因素.未来需要增加样本量、增加随访时间进一步明确血清UA与BPPV的关系.Objective To confirm the possible relationships between serum level of uric acid （UA） and benign paroxysmal positional vertigo （BPPV）.Methods A total of 87 patients with BPPV and 36 ageand gender-matched control subjects were recruited from our hospital between July 1,2013 and July 1,2014.All patients underwent a complete audio-vestibular test battery,such as Dix-Hallpike maneuver for posterior semicircular canal and supine roll test for horizontal semicircular canal.All risk factors such as the histories of heart and cerebral vascular diseases,and routine hematological and biochemical analyses were analyzed between two groups.Results No significant inter-group differences existed in age,gender,histories of hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease,smoking or drinking （P 〉 0.05）.No significant differences existed between systolic blood pressure,diastolic blood pressure,ejection fraction,whole blood count,lipid profile,homocysteine,prealbumin and blood urea nitrogen in patients with BPPV compared with controls （P 〉 0.05）.However,the values of UA （267 ± 86 vs 325 ± 75）μmol/L,hemoglobin a1 c （5.6 ± 1.4 vs 6.5 ± 1.0） %,albumin （36 ± 4 vs 40 ± 4） g/L and creatinine （72 ±20 vs 81 ± 22） μmol/L were much lower in patients with BPPV versus controls （P 〈 0.05）.According to multiple Logistic regression model,the lower levels of hemoglobin a1 c and albumin were independently associated with BPPV （P 〈 0.05） with the odds ratio of 1.473 （95% CI 1.066-2.037） and 1.162 （95% CI 1.025-1.318）,respectively.However,the level of UA was not independently correlated with the occurrence of BPPV [OR =1.005 （95 % CI 1.000-1.011）,P =0.063].Conclusion The lower levels of hemoglobin a1 c and albumin are independently associated with BPPV.Although the value of UA is lower in patients with BPPV versus controls,it is not an independent risk factor for BPPV.Due to limited patient data,further studies are needed to clarify the association in a larger s

关 键 词：良性阵发性位置性眩晕 尿酸 

分 类 号：R741[医药卫生—神经病学与精神病学]