中老年女性良性阵发性位置性眩晕反复发作者钙代谢研究  

Calcium Metabolism in Recurrent Benign Paroxysmal Positional Vertigo in Middle Aged and older Women

作　　者：王志斌 姚光辉 陶祥明 张金翠 吴子明[3] WANG Zhibin;YAO Guanghui;TAO Xiangming;ZHANG Jincui;WU Ziming(Vertigo Clinic,Department of Otorhinolaryngology,Bengbu Third People's Hospital Affiliated to Bengbu Medical College,Bengbu,Anhui 233000,China;Department of General Medicine,Bengbu Third People's Hospital Affiliated to Bengbu Medical College,Bengbu,Anhui 233000,China;Vertigo Center,Department of Otorhinolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing 100853)

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院耳鼻喉科眩晕门诊,蚌埠233000 [2]蚌埠医学院附属蚌埠市第三人民医院全科医学,蚌埠233000 [3]解放军总医院耳鼻咽喉头颈外科眩晕诊疗中心,北京100853

出　　处：《中华耳科学杂志》2019年第6期852-856,共5页Chinese Journal of Otology

基　　金：蚌埠市卫计委技术推广项目(2018-TGXM04);蚌埠市科技计划项目(20160325);蚌埠医学院自然科学基金重点项目(BYKY18166);解放军后勤保障部保健课题(16BJZ18)~~

摘　　要：目的比较反复发病中老年女性良性阵发性位置性眩晕患者与健康对照组之间骨密度、25-(OH)维生素D、血钙浓度差异,探讨其发病及复发的相关性。方法选取2016年10月~2018年12月就诊于我院眩晕门诊纳入标准的103例明确诊断的50岁以上女性患者,首次治愈1年内,再发(≥2次)的BPPV患者为研究对象(A组),选取同期来院体检的年龄匹配且近1年无眩晕病史正常女性80例为对照组(B组)。采用超声骨密度仪检测患者足跟骨密度,运用全自动分析仪比色法检测血钙浓度,电化学法检测血清25-(OH)维生素D水平。比较各组间骨密度、血钙浓度和血清25-(OH)维生素D水平。结果 A组骨量减少占39.81%(41/103),骨质疏松占29.13%(30/103)高于B组骨量减少36.25%(29/80),骨质疏松16.25%(13/80),差异有统计学意义。血钙浓度差异无统计学意义。B组的25-(OH)维生素D(23.847±3.125 ng/ml)高于A组(17.153±2.028 ng/ml),差异有统计学意义(t=17.511,P<0.05);A组中,未绝经人数占20.39%(21/103)骨密度T(-1.738±0.923)低于绝经组(-2.392±1.142),差异有统计学意义(t=-2.426,P<0. 05);血清25(OH)D(21.589±3.037 ng/ml)高于绝经组(16.231±2.102 ng/ml),差异有统计学意义(t=9.454, P<0. 05);血钙浓度(2.365±0.521 mmol/L)与绝经组(2.353±0.514 mmol/L)相比,差异无统计学意义(t=0.095,P>0. 05)。结论反复发病中高年女性特发性BPPV患者发病可能与骨密度及血清维生素D水平下降有关,绝经后女性更易累及。Objective To investigate the association of bone mineral density and 25-(OH) vitamin D levels with benign paroxysmal positional vertigo(BPPV) and its recurrence. Methods One hundred and three women who were 50 years or older and diagnosed with BPPV between October 2016 and December 2018 with more than 2 recurrences in the past 1 year were selected as the study group(A) and 80 age-matched women without vertigo in the past 1 year served as the control(group B). Bone mineral density was tested using an ultrasound bone densitometer, and serum levels of calcium and 25-(OH) vitamin D were measured by automatic analyzer colorimetric assay and electrochemistry, respectively.Results Bone loss was seen in 41(39.81%) and osteoporosis in 30(29.13%) of the 103 patients in group A, higher than in group B(29/80 [36.25%] and 13/80 [16.25%], respectively)(P<0.05). Serum level of 25-(OH) vitamin D in group B(23.847±3.125 ng/ml) was higher than in group A, while serum calcium levels showed no significant difference between groups A and B. In group A, bone mineral density T(-1.738±0.923) in non-menopause patients(20.39%, 21/103)was lower than in menopaused patients(-0.938 ± 0.923)(P<0. 05), despite their higher levels of 25-(OH) vitamin D(21.589±3.037 ng/ml vs 16.231±2.102 ng/ml)(P<0. 05). There was no statistically significant difference in serum calcium levels between non-menopause(2.365±0.521 mmol/L) and menopaused patients(-2.392±1.142 mmol/L). Conclusion Recurrent BPPV in middle aged and older women may be associated with reduced bone mineral density and serum vitamin D levels, especially in postmenopausal women.

关 键 词：良性阵发性位置性眩晕 骨密度 25-(OH)维生素D 

分 类 号：R764[医药卫生—耳鼻咽喉科]