眩晕中心门诊1419例患者的病因分层研究  

Stratified analysis of 1419 cases of vertigo/dizziness

作　　者：王朝霞[1] 李远军[1] 徐先荣[1] 罗金叶 翟丽红[1] Wang Zhaoxia;Li Yuanjun;Xu Xianrong;Luo Jinye;Zhai Lihong(Vertigo Clinical Research Center of Aerospace,Air Force General Hospital of PLA,Beijing 100142,China)

机构地区：[1]空军总医院航空航天眩晕诊疗研究中心,北京100142

出　　处：《中华临床医师杂志（电子版）》2018年第4期218-222,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金："十二五"国家科技支撑计划课题(2012BAI12B02);全军后勤面上项目(CKJ14J013);全军后勤重点项目(BKJ15J004);全军后勤标准制定项目(BKJ15B013)

摘　　要：目的总结眩晕中心门诊患者的疾病病因规律,为眩晕/头晕的精确诊疗提供依据。方法从2016年1～12月期间空军总医院眩晕中心门诊诊治的6450例次病例中,选择具有全科医师工作经历并长期从事眩晕诊疗和研究的某专家团队诊治的眩晕/头晕患者1419例作为研究对象,按患者性别和年龄进行病因分层的构成比分析。采用χ~2检验比较不同性别病因分层的构成比差异。结果 (1)眩晕/头晕患者前9位病因为良性阵发性位置性眩晕(BPPV)占38.55%(547/1419)、前庭性偏头痛(VM)占21.92%(311/1419)、前庭神经炎(VN)占7.89%(112/1419)、梅尼埃病(MD)占6.20%(88/1419)、精神性眩晕(PV)占4.65%(66/1419),高血压占3.24%(46/1419)、后循环缺血(PCI)占2.54%(36/1419)、突发性耳聋伴眩晕(SD)占1.48%(21/1419)、冠状动脉粥样硬化性心脏病(CHD)占0.85%(12/1419)。按眩晕分类前庭外周性眩晕占56.03%(795/1419),中枢性眩晕占24.59%(349/1419),非前庭系统全身疾病所致眩晕/头晕占10.50%(149/1419),不明原因眩晕/头晕占8.88%(126/1419)。(2)患者年龄9～90岁,按年龄病因分层,排在前4位的为:<18岁组BPPV(0.42%,6/1419)、晕动病(0.42%,6/1419)、VM(0.35%,5/1419)、VN(0.21%,3/1419),共26例;18～44岁组为BPPV(11.35%,161/1419)、VM(7.26%,103/1419)、VN(2.47%,35/1419)、MD(1.20%,17/1419),共412例;45～59岁组为BPPV(15.01%,213/1419)、VM(8.25%,117/1419)、MD(3.38%,48/1419)、VN(2.68%,38/1419),共548例;60～74岁组为BPPV(10.36%,147/1419)、VM(4.79%,68/1419)、高血压(2.11%,30/1419)、VN(2.11%,30/1419),共343例;75～90岁组为PCI(2.54%,36/1419)、BPPV(1.41%,20/1419)、VM(1.27%,18/1419)、VN(0.42%,6/1419),共90例。(3)患者男:女为1:1.79。按性别病因分层,PV和不明原因以女性多见(χ~2=4.02,P=0.044;χ~2=29.94,P <0.001),高血压和PCI以男性多见,差异具有统计学意义(χ~2=17.90,21.32,P均<0.001)。结论眩晕/头晕表现复杂、诊断困难,涉及多个传统学科,眩晕中心门诊与其他专科门诊的�Objective To summarize the etiology of vertigo/dizziness to provide evidence for the accurate diagnosis and treatment of vertigo or dizziness.Methods 6450 patients with vertigo/dizziness symptoms visiting the Clinical Center for Vertigo of Air Force General Hospital of PLA from January to December 2016,1419 diagnosed with vertigo/dizziness by a team of experts who had general practitioners experience were selected for etiology stratified analysis by gender and age.Theχ2-test was used to compare the constitution ratio of etiological stratification by sex.Results Top 9 etiological factors of vertigo/dizziness were benign paroxysmal positional vertigo(BPPV;38.55%,547/1419),vestibular migraine(VM;21.92%,311/1419),vestibular neuritis(VN;7.89%,112/1419),Meniere disease(MD;6.20%,88/1419),psychic vertigo(PV;4.65%,66/1419),hypertension(3.24%,46/1419),cerebral infarction(PCI;2.54%,36/1419),chronic subjectivity vertigo(CSV;1.83%,26/1419),sudden deafness with vertigo(SD;1.48%,21/1419),and coronary heart disease(CHD;0.85%,12/1419).Vestibular peripheral vertigo accounted for 56.03%(795/1419)of all cases,central vertigo accounted for 24.59%(349/1419),vertigo/dizziness caused by systemic disease accounted for 10.50%(149/1419),and unexplained vertigo/dizziness accounted for 8.88%(126/1419).For patients aged between 9-90 years,top 4 etiological factors stratified by age were:<18 age group(n=26):BPPV(0.42%,6/1419),motion sickness(0.42%,6/1419),VM(0.35%,5/1419),and VN(0.21%,3/1419);18-44 age group(n=412):BPPV(11.35%,161/1419),VM(7.26%,103/1419),VN(2.47%,35/1419),and MD(1.20%,17/1419);45-59 age group(n=548):BPPV(15.01%,213/1419),VM(8.25%,117/1419),MD(3.38%,48/1419),and VN(2.68%,38/1419);60-74 age group(n=343):BPPV(10.36%,147/1419),VM(4.79%,68/1419),hypertension(2.11%,30/1419),and VN(2.11%,30/1419);and 75-90 age group(n=90):PCI(2.54%,36/1419),BPPV(1.41%,20/1419),VM(1.27%,18/1419),and VN(0.42%,6/1419).The male/female ratio was 1:1.79 among the 1419 patients.PV and unexplained vertigo/dizziness were more common in females(χ2=4.02,29.9

关 键 词：眩晕 病因分析 全科医学 精确诊疗 

分 类 号：R441.2[医药卫生—诊断学]