良性阵发性位置性眩晕患者复位治疗后复发相关因素调查及站立平衡功能分析  

Factors related to recurrence and standing balance function in benign paroxysmal positional vertigo patients after repositioning manoeuvre

作　　者：连蕾[1] 韩海平[1] 冯志星[1] LIAN Lei;HAN Haiping;FENG Zhixing(Department of Otorhinolaryngology,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院耳鼻咽喉科,河北邯郸056001

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第6期48-52,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：河北省医学科学研究课题(20211144)。

摘　　要：目的探讨良性阵发性位置性眩晕(BPPV)患者复位治疗后复发的因素,分析BPPV患者站立平衡功能。方法选择2019年2月—2020年12月收治的209例BPPV患者,所有患者手法复位治疗后均接受定期电话随访,根据随访期间是否发生复发将患者分为复发组(48例)和无复发组(161例)。通过收集临床资料,采用多因素Logistic回归分析BPPV复发的危险因素。选择60例体检者为对照组,采用感觉整合试验(SOT)评估动态站立平衡功能,采用感觉相互作用与平衡的改良临床试验(mCTSIB)评估静态站立平衡功能,并比较BPPV组累及不同半规管患者以及对照组间动态和静态站立平衡功能差异性。结果复发组年龄≥50岁、女性、高血压、高脂血症、糖尿病、眩晕持续时间≥1周、复位次数≥3次比例高于无复发组(P<0.05)。多因素Logistic回归分析结果示年龄≥50岁、女性、糖尿病、高血压、高脂血症是BPPV手法复位后复发的危险因素(P<0.05)。BPPV组累及后半规管患者睁眼-测力板稳定-视景随动(CON 3)、睁眼-测力板随动-视景稳定(CON 4)、闭眼-测力板随动-视景稳定(CON 5)、睁眼-测力板随动-视景随动(CON 6)SOT平衡得分低于对照组(P<0.05),站立于海绵垫睁眼和闭眼时重心晃动的平均速度大于对照组(P<0.05)。结论年龄≥50岁、女性、高血压、高脂血症、糖尿病是BPPV手法复位后复发的危险因素,累及后半规管的BPPV患者可能容易发生站立平衡功能异常。Objective To investigate the recurrence factors and analyze the standing balance function in benign paroxysmal positional vertigo(BPPV)patients after repositioning maneuver.Methods A total of 209 BPPV patients(BPPV group)admitted to our department from Feb 2019 to Dec 2020 were included.All patients received regular telephone follow-up after repositioning maneuvers,and were divided into recurrence group(n=48)and non-recurrence group(n=161)according to follow-up results.Sixty healthy subjects were selected as control.By collecting clinical data,the risk factors for recurrence of BPPV were analyzed by multivariate logistic regression.The sensory organization test(SOT)and the modified clinical test of sensory interaction and balance(mCTSIB)were used to evaluate their static standing balance function.The dynamic and static standing balance function was compared among BPPV patients with different semicircular canal involvement and between the BPPV group and the control group.Results The proportions of age≥50 years old,female,hypertension,hyperlipidemia,diabetes,vertigo duration≥1 week and reduction times≥3 in the recurrence group were higher than those in the non-recurrence group(P<0.05).Multivariate logistic regression analysis showed that age≥50 years old,female,diabetes,hypertension and hyperlipidemia were risk factors for recurrence after repositioning maneuver of BPPV(P<0.05).The SOT balance scores at open eyes-force plate stability-visual scene follow-up(CON 3),open eyes-force plate follow-up-visual scene stability(CON 4),closed eyes-force plate follow-up-visual scene stability(CON 5),open eyes-force plate follow-up-visual scene follow-up(CON 6)of BPPV group with posterior canal involvement were lower than those of the control group(P<0.05),and the average velocities of center of gravity shaking when standing on sponge pad with eyes open and closed were higher than those of the control group(P<0.05).Conclusion Age≥50 years old,female,hypertension,hyperlipidemia and diabetes are risk factors for recurre

关 键 词：良性阵发性位置性眩晕 高龄 女性 后半规管 平衡功能 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]