良性阵发性位置性眩晕再发的风险因素调查与分析  

An Analysis of Risk Factors for Short-Tsincerm Recurrence of Benign Paroxysmal Positional Vertigo

作　　者：宋玉玉 张祎[1] 牛彦婷 贾若[1] 刘瑞琪 刘博[1] SONG Yuyu;ZHANG Yi;NIU Yanting;JIA Ruo;LIU Ruiqi;LIU Bo(Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Otolaryngology,Key Laboratory of Otorhinolaryngology Head and Neck Surgery,Ministry of Education,Beijing 100730)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室,北京100730

出　　处：《中华耳科学杂志》2022年第1期32-37,共6页Chinese Journal of Otology

基　　金：北京市科委首都市民健康培育项目(Z151100003915100);首都卫生科研发展专项(首发2016-3-1091);首都医科大学附属北京同仁医院“重点医学发展计划”(trzdyxzy201802)。

摘　　要：目的探讨影响良性阵发性位置性眩晕(Benign Paroxysmal Positional Vertigo,BPPV)患者再发的危险因素。方法纳入2020年8月-2021年6月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科首次确诊并治愈的131例BPPV患者。全部患者登记信息,进行前庭功能检查、纯音测听,填写耳鸣情况,记录是否伴有高血压、糖尿病、高脂血症、骨质疏松症等基本信息,同时进行头晕评价量表(Dizziness Handicap Inventory,DHI)、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)和匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)评价。治疗后6个月进行电话或门诊随访,记录是否再发,对结果进行统计学分析。结果(1)随访期内有23例BPPV患者再发,再发率17.6%(23/131),平均年龄46.48±13.32岁;108例未再发(108/131),平均年龄56.44±12.57岁;再发组年龄小于未再发组(Z=-3.281,P=0.001)。再发组中男性6例,女性17例,未再发组中男性25例,女性83例,两组性别差异无统计学意义(χ^(2)=0.091,P=0.763)。(2)伴有慢性疾病的患者72例,其中再发患者14例,再发组与未再发组患者慢性疾病患病率无显著差异(χ^(2)=0.393,P=0.531)。(3)再发组患者的HADS量表焦虑评分高于未再发组(Z=-2.718,P=0.005),而抑郁评分差异无统计学意义(Z=-1.090,P=0.276);且DHI量表总分及躯体、情感、功能三个维度评分、PSQ评分在两组间差异无统计学意义(P>0.05)。(4)再发组前庭功能异常率42.9%,未再发组患前庭功能异常率42.9%,两组差异无统计学意义(P=1)。结论随访6个月结果提示BPPV短期再发的患者的年龄更年轻,再发患者的焦虑情绪明显,提示临床应加强综合治疗和定期的临床随访。Objective To identify risk factors for recurrence in patients with benign paroxysmal positional vertigo(BPPV).Methods A total of 131 patients with BPPV first diagnosed and treated at the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,from August 2020 to June 2021 were enrolled,Following registering general information,patients received vestibular function examination,pure tone audiometry and tinnitus evaluation,as well as information of systemic conditions,e.g.hypertension,diabetes,hyperlipidemia,osteoporosis,etc.The Dizziness Handicap Inventory(DHI),Hospital Anxiety and Depression Scale(HADS)and Pittsburgh Sleep Quality Index(PSQI)were completed.Patients were followed up by telephone or outpatient visit at 6 months after treatment.Recurrences were documented and analyzed.Results During the follow-up period,BPPV recurred in 23 Patients(23/131,17.6%).Their average age was 46.48±13.32 years,younger than the 108 patients with no recurrence(56.44±12.57 years)(Z=-3.281,P=0.001).The male/female ratio was 6/17 in the recurrence group and 25/83 in the non-recurrence group(χ^(2)=0.091,P=0.763).Chronic systemic diseases were reported by 72 patients,including 14 patients with recurrences(χ^(2)=0.393,P=0.531).The HADS anxiety score in the recurrence group was higher than that in the non-recurrence group(Z=-2.718,P=0.005),but not the depression score(P>0.05),the DHI scale or the PSQI scores(P>0.05).The rate of abnormal vestibular function tests was 42.9%in both the recurrence and non-recurrence groups(P=1).Conclusion The 6 months follow-up results in this group of patients suggest increased levels of anxiety in patients with recurrence of BPPV,indicating a need for a comprehensive treatment approach and regular follow-ups.

关 键 词：良性阵发性位置性眩晕 再发 慢性疾病 焦虑 

分 类 号：R764[医药卫生—耳鼻咽喉科]