血管性危险因素对良性阵发性位置性眩晕季节性规律的影响  

Influence of vascular risk factors on seasonality of benign paroxysmal positional vertigo

作　　者：姜睿璇 曹振汤 陈梅梅[1] 王琰[1] 鞠奕[1] 赵性泉[1] Jiang Ruixuan;Cao Zhentang;Chen Meimei;Wang Yan;Ju Yi;Zhao Xingquan(Department of Neurology,Clinical Center for Vertigo and Balance Disturbance,China National Clinical Research Center for Neurological Diseases Research Unit of Artificial Intelligence in Cerebrovascular Disease,Chinese Academy of Medical Sciences,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心,首都医科大学眩晕临床诊疗与研究中心,国家神经系统疾病临床医学研究中心,中国医学科学院脑血管病人工智能研究创新单元,北京100070

出　　处：《中华医学杂志》2021年第29期2310-2315,共6页National Medical Journal of China

基　　金：神经系统重大疾病创新药物临床评价技术平台建设(2017ZX09304018);中国医学科学院医学与健康科技创新工程项目(2019-I2M-5-029);北京市科委医药协同科技创新研究专项(Z201100005620010);北京市临床重点专科项目-培育和建设项目北京市临床重点专科项目-卓越项目。

摘　　要：目的研究良性阵发性位置性眩晕(BPPV)发病的季节性特点,同时探讨血管性危险因素与BPPV季节性规律之间的关系。方法回顾性分析2016年1月1日至2019年12月31日首都医科大学附属北京天坛医院神经内科前庭功能检查室数据库中诊断为BPPV、并进行手法或仪器复位的3886例患者信息,记录患者的人口学信息和病史等内容。获取北京市四年来全年气温数据并计算每月平均值。采用χ2检验、非参数检验、Spearman相关系数和logistic回归研究BPPV发病与温度、季节的关系,同时探讨血管性危险因素对BPPV季节性规律的影响。结果BPPV患者中女性更多见(2667例,68.6%),男女比约为1∶2。患者年龄为18~90(55±13)岁。春季(3~5月)、夏季(6~8月)、秋季(9~11月)和冬季(12月至次年2月)BPPV的发病例数依次为1000例(25.7%)、911例(23.4%)、808例(20.8%)和1167例(30.0%)(P=0.027)。BPPV发病高峰在12月份(n=491),9月发病例数最低(n=251)。月度诊断的BPPV例数和平均气温呈负相关(R2=0.317,P<0.001)。相比于无血管性危险因素的患者,合并≥2个危险因素的患者在春冬季的发病比例更高(OR=1.32,95%CI:1.13~1.53,P<0.001)。随着危险因素的增多,春冬季节BPPV发病比例增加(趋势P<0.001)。结论BPPV好发于寒冷季节(春冬季),发病例数与气温呈负相关。相比于无血管性危险因素者,血管性危险因素越多者在春冬季节发病的比例越高。Objective To investigate the seasonal changes of benign paroxysmal positional vertigo(BPPV)onset,and explore the relationship between vascular risk factors and the seasonal patterns of BPPV.Methods Data of 3886 patients subjected to vestibular function examination and diagnosed with BPPV who underwent manipulation or instrumental repositioning from January 1,2016 to December 31,2019 in the Department of Neurology,Beijing Tiantan Hospital were retrospectively analyzed.Demographic information and medical history of the patients were recorded.Weather temperature data of Beijing were obtained and monthly averages were calculated.The relationship between the BPPV onset and temperature and seasonality was investigated.Meanwhile,the influence of vascular risk factors on the seasonal patterns of BPPV was determined.Results BPPV is more common in women(n=2667).The male to female ratio of patients was approximately 1∶2,with a mean age of(55±13)years.The cases of BPPV in spring(March-May),summer(June-August),autumn(September-November)and winter(December-February)were 1000(25.7%),911(23.4%),808(20.8%)and 1167(30.0%),respectively.The peak incidence of BPPV occurred in December(n=491)and the lowest occurred in September(n=251).The number of BPPV cases diagnosed monthly was inversely correlated with mean temperature(R2=0.317;P<0.001).Patients with≥2 vascular risk factors were at higher risk of developing BPPV in spring or winter than those without risk factors(OR=1.32,95%CI:1.13-1.53,P<0.001).Proportion of onset in spring or winter increased with each additional risk factor(P trend<0.001).Conclusions BPPV often occurs in the months with low temperature(spring and winter)and the number of cases is inversely correlated with temperature.Compared with those with no vascular risk factors,patients with more vascular risk factors are more likely to develop BPPV in spring and winter.

关 键 词：头晕 眩晕 前庭疾病 季节 危险因素 

分 类 号：R764[医药卫生—耳鼻咽喉科]