良性阵发性位置性眩晕与脂蛋白(a)的相关性研究  

Relationship between Lipoprotein(a)and Benign paroxysmal positional vertigo

作　　者：陈茹[1] 陈了之[1] 李先辉[1] 苏小青[1] 陈崇喜[1] 黄益灯 

机构地区：[1]温州医科大学附属第三医院耳鼻咽喉科,浙江温州325200 [2]解放军第118医院耳鼻咽喉头颈外科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2017年第1期5-8,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的检测良性阵发性位置性眩晕(Benign paroxysmal positional vertigo BPPV)中的脂蛋白(a)[Lipoprotein(a)LP(a)],并探讨相关性及其临床意义。方法收集2016年1月至6月在温州医科大学附属三院耳鼻咽喉科收治的BPPV患者40例作为实验组,选取40例年龄、性别相匹配的无眩晕健康体检人员作为对照组。两组均予采集血管相关危险因素(高血压、糖尿病、冠心病等),并测定脂蛋白(a)[LP(a)]、甘油三酯TG、总胆固醇TC、高密度胆固醇HDL-C、低密度胆固醇LDL-C、载脂蛋白Apo A1及载脂蛋白Apo B,并计算Apo B/Apo A1比值。使用SPSS16.0统计软件进行卡方检验及回归分析。结果与年龄、性别匹配的健康对照组相比,BPPV患者在既往血管相关危险因素(高血压、糖尿病、冠心病)、TC、TG、LDL-C、Apo B和Apo B/Apo A1比值等方面差异无统计学意义(P>0.05)。LP(a)[(142.52±83.90)mg/L比(63±113.39)mg/L]、HDL-C[(1.42±0.22)mmol/L比(1.35±0.22)mmol/L]、Apo A1[(1.48±0.15)mmol/L比(1.40±0.18)mmol/L],以上三个指标BPPV组显著高于健康对照组,差异具有统计学意义(P<0.05)。多因素logistic回归模型,结果发现TC是BPPV发病的影响因素[OR=1192.516,95%CI=(3.691,385247),P=0.016],TG、HDL-C为BPPV发病的危险因素OR(95%CI)分别是0.070(0.010~0.505)(P<0.05)、0.028(0.000~0.407)(P<0.05),并未发现LP(a)是BPPV发生的独立预测因子[OR=1.005(1.000~1.011),P=0.063(P>0.05)]。结论本研究发现BPPV患者中脂蛋白(a)明显升高,但没有得出脂蛋白(a)是BPPV发生的独立危险因素。有待日后增加样本量进一步深入研究。Objective To investigate the relationships between Lipoprotein（a）[LP（a）] and benign paroxysmal positional vertigo（BPPV）. Methods 40 patients with BPPV and 40 cases of age and gender matched healthy persons without vertigo as the control subjects were recruited from our hospital from January 1,2016 to June 1,2016. All related risk factors（such as hypertension, diabetes,coronary heart disease） were collected and the levels of Lipids [LP（a）,triglyceride（TG）,total cholesterol（TC）,high density 1ipopmtein cholesterol（HDL—c）,low density lipopmtein（LDL—C）, apolipoprotein（apo） et al] were analyzed between two groups. Results No significant intergroup differences existed in age, gender, histories of hypertension, diabetes, coronary heart disease（P〈0.05）. No significant differences existed between TC、TG、LDL-C、Apo B and Apo B/Apo A1 in patients with BPPV compared with controls（P〈0.05）. However, the values of LP（a） [（142.52 ±83.90）mg/L VS（63 ±113.39）mg/L]、HDL-C [（1.42 ±0.22）mmol/LVS（1.35 ±0.22）mmol/L]and apo A1[（1.48±0.15）mmol/LVS（1.40±0.18）mmol/L] were much higher in patients with BPPV versus the controls（P0.05）.According to multiple Logistic regression model, the levels of TC were influence factors associated with BPPV [OR =1192.516,95% CI =（3.691,385247）,P=0.016],the levels of TG and HDL-C were independently associated with BPPV（P0.05） with the odds ratio of0.070（0.010~0.505）（P0.05）、0.028（0.000~0.407）（P0.05）,the levels of LP（a） were not independently correlated with BPPV（P0.05）with the odds ratio of 1.005（1.000~1.011）,P=0.063（P0.05）. Conclusion Although the value of LP（a）is higher in patients with BPPV versus controls,it is not an independent risk factor for BPPV. Due to limited patients＇ data, further studies are needed to clarify the association in a larger sample size of different ethnic groups or longer follow ups.

关 键 词：良性阵发性位置性眩晕 脂蛋白(a) 载脂蛋白 

分 类 号：R764[医药卫生—耳鼻咽喉科]