老年良性阵发性位置性眩晕复发及死亡的临床研究  

Clinical study of recurrence and mortality in elderly patients with benign paroxysmal positional vertigo

作　　者：邱崇荣 刘向红[1] 周宇明[1] 肖小六[1] 彭金亮 郭树平 QIU Chong-rong;LIU Xiang-hong;ZHOU Yu-ming;XIAO Xiao-liu;PENG Jing-liang;GUO Shu-ping(Department of Emergency,Ganzhou People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]赣州市人民医院急诊科,江西赣州341000

出　　处：《赣南医学院学报》2022年第1期57-61,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨老年良性阵发性位置性眩晕(Benign paroxysmal positional vertigo,BPPV)复发及死亡的危险因素,为临床控制危险因素、减少复发及降低死亡风险发生提供理论依据。方法:回顾性连续纳入我院2013年12月30日至2018年9月23日明确诊断为良性阵发性位置性眩晕住院患者共1366例,根据年龄是否大于等于65岁分为老年组和非老年组,其中老年组570例,非老年组796例。收集患者临床基本资料,并进行随访,以复发或出院后任何原因死亡为主要不良心血管事件(Major adverse cardiovascular events,MACE)进行记录。结果:与非老年组比较,老年组女性比例较低,高血压病、糖尿病、冠心病比例较高,入院收缩压较高,尿素氮、肌酐、尿酸水平较高,TC、LDL-c水平较低,TBiL、DBiL水平较高,颈部血管斑块发生率较高,MACE发生率较高(P均<0.05)。单因素Logistic回归分析结果显示:吸烟(OR=1.844,P=0.012,95%CI 1.143~2.975)、高血压(OR=1.597,P=0.012,95%CI 1.109~2.299)、心率(OR=1.025,P=0.002,95%CI 1.009~1.042)、尿素氮(OR=1.137,P=0.001,95%CI 1.053~1.228)、肌酐(OR=1.005,P=0.045,95%CI 1.000~1.011)是发生MACE的危险因素。多因素Logistic回归分析结果显示:吸烟(OR=1.747,P=0.029,95%CI 1.058~2.884)、高血压病(OR=1.516,P=0.030,95%CI 1.041~2.209)、心率(OR=1.023,P=0.005,95%CI 1.007~1.040)、尿素氮(OR=1.116,P=0.015,95%CI 1.021~1.220)是发生MACE的危险因素。结论:老年BBPV患者戒烟、控制血压,定期复查肾功能,对这些危险因素进行控制可减少复发、降低死亡风险,改善老年BBPV患者生活质量。Objective:To investigate recurrence and mortality in elderly patients with benign paroxysmal positional vertigo,to provide theoretical basis for clinical control of risk factors,reduction of recurrence and reduction of death risk.Methods:A total of 1366 cases with benign paroxysmal positional vertigo were included in our hospital from December 2013 to September 2018.They were divided into elderly group(n=570)and non-elderly group(n=796),according to whether the age is greater than or equal to 65 years old.Collect baseline characteristics between the two groups,with data collection and clinical follow-up.The major adverse cardiovascular events(MACE)were observed.The recurrence and any cause of death of MACE were recorded.Results:The elderly patients with benign paroxysmal positional vertigo showed the following characters compared with non-elderly patients:the female ratio was lower,hypertension,diabetes,coronary heart disease were higher;systolic pressure was higher at admission,the level of urea,nitrogen creatinine,uric acid were higher;the level of total cholesterol was lower;the level of low density lipoprotein cholesterol was lower;the level of total bilirubin was higher;the level of indirect bilirubin was higher;the cervical plaque was higher;MACE was higher;The differences were significant(P<0.05).Logistic regression analysis indicated that smoking[odds ration(OR)1.747,95%CI(confidence interval)1.058-2.884,P=0.029];hypertension[OR 1.516,95%CI 1.041-2.209,P=0.030];heart ratio[OR 1.023,95%CI 1.007-1.040,P=0.005];nitrogen creatinine[OR 1.116,95%CI 1.021-1.220,P=0.015]was the independent predictors of MACE.Conclusion:Elderly patients with benign paroxysmal positional vertigo should quit smoking,control hypertension,have regular review of renal function.The control of these risk factors will reduce recurrence and mortality,and improve the quality of life.

关 键 词：老年人 良性阵发性位置性眩晕 复发 死亡 不良事件 

分 类 号：R743.9[医药卫生—神经病学与精神病学]