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  

The relationship between the recurrence of benign paroxysmal positional vertigo and the level of bone mineral as well as estrogen in postmenopausal women

作　　者：张云美[1] 杨振栋 李万鑫[1] 时晨 于亚峰[1] Zhang Yunmei;Yang Zhendong;Li Wanxin;Shi Chen;Yu Yafeng(Department of Otorhinolaryngology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院耳鼻咽喉科,苏州215006

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第12期881-884,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：江苏省卫计委课题（H2017061）;苏州市医学重点学科项目（SZXK201503）;苏州市科技局项目（SYS201449）

摘　　要：目的 探讨绝经女性良性阵发性位置性眩晕（BPPV）的复发与骨密度及雌激素水平的关系.方法 选取2013年12月至2017年6月在苏州大学附属第一医院诊治的38例绝经女性BPPV患者作为实验组,所有患者均自然绝经1年以上;患者均在眼震视图仪下行Dix-Hallpike试验和滚转试验后确诊为BPPV,并且反复发作至少2次及以上.选择同期49例正常绝经的健康女性作为对照组.通过双能X射线吸收法测定受试者腰椎的骨密度;清晨抽取受试者空腹静脉血检测血清雌激素（雌二醇）水平.采用SPSS 21.0软件比较两组女性骨密度和雌二醇水平.将复发的BPPV患者中骨密度下降者分为治疗组和未治疗组,比较12个月内再次复发情况.结果 实验组血清雌二醇水平和骨密度值分别为（16.21±11.00） ng/L和-1.68 ±0.98,明显低于对照组的（28.52±6.34） ng/L和-0.18 ±0.77,差异具有统计学意义（t值分别为7.03、8.05,P值均〈0.05）.实验组中骨密度下降者占78.9％（30/38例）,对照组骨密度下降者占12.2％（6/49例）,二者比较差异有统计学意义（P〈0.05）.实验组中治疗组BPPV的复发率[17.6％（3/17例）]较未治疗组[61.5％（8/13例）]明显降低,差异有统计学意义（P〈0.05）.结论 反复发作的绝经女性BPPV患者雌激素水平和骨密度值较低,采取积极的治疗措施可减少BPPV发作次数.Objective To investigate the relationship between the recurrence of benign paroxysmal positional vertigo（BPPV） and the levels of bone mineral density （BMD） and estrogen in postmenopausal women.Methods A total of 38 postmenopausal women with recurrent BPPV were recruited as study group,in the First Affiliated Hospital of Soochow University from December 2013 to June 2017.Meanwhile,49 normal menopausal women were included as control.All patients were natural menopausal for over one year.The patients were diagnosed as BPPV based on results of Dix-Hallpike test and Roll-test,with at least two episodes of recurrent onset.In the subjects,BMD was measured by dual X-ray absorptiometry of lumbar vertebrae.Estrogen levels were obtained by testing serum estradiol （E2） levels in early morning fasting venous blood.In the present study,we compared the level of E2 and the value of BMD in two groups by SPSS 21.0.In the study group,patients with decreased BMD were divided into two groups：treatment and untreated group.The recurrence rate of BPPV was compared between the two groups within 12 months.Results ①The averagel levels of E2 and BMD in the study group were （16.21 ± 11.00） ng/L and-1.68 ± 0.98） respectively,which were significantly lower than those in the control group （t value was 7.03 and 8.05 respectively,both P 〈 0.05）.The averagel levels of E2 and BMD incontrol group were （28.52 ± 6.34）ng/L and-0.18 ± 0.77 respectively.②The number of patients with decreased BMD in the study group （30 cases） was more than that in control group （6 cases）,and the difference was statistically significant （P 〈 0.05）.③ The recurrence rate of BPPV in treatment group [17.6% （3/17）] was significantly lower than that of untreated group [61.5% （8/13）],and the difference was statistically significant （P 〈 0.05）.Conclusion Recurrent BPPV in postmenopausal women usually accompany with low levels of estrogen and BMD.Active treatment is helpful for their recurrence of BPPV.

关 键 词：眩晕 雌激素类 骨密度 绝经后期 

分 类 号：R580[医药卫生—内分泌] R764[医药卫生—内科学]