神经内科门诊良性阵发性位置性眩晕发病与复发因素分析  

Factors for Onset and Recurrence of Benign Paroxysmal Positional Vertigo in Neurology Department

作　　者：姜佩依 赵婷 张思然 孔琦 楼跃[2] JIANG Peiyi;ZHAO Ting;ZHANG Siran;KONG Qi;LOU yue(Zhejiang Chinese Medical University,Hangzhou,310053;Department of Neurology,Zhejiang Hospital,Hangzhou,310013)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江医院神经内科,杭州310013

出　　处：《中华耳科学杂志》2023年第4期458-463,共6页Chinese Journal of Otology

摘　　要：目的分析良性阵发性位置性眩晕(Benign Paroxysmal Positional Vertigo,BPPV)发病的临床特征,探讨影响BPPV发病的影响因素及复发特点,为临床预防与治疗提供更多参考依据。方法回顾性分析2019年1月份至2020年12月份在浙江医院神经内科眩晕中心确诊、并完成仪器复位的1119例BPPV患者的一般人口学资料和病史信息。此外,跟踪记录BPPV患者的复发情况。采用Spearman秩相关性分析对BPPV发病和复发与月份的关系进行研究。按照年龄是否≥60岁分为老年组和非老年组,对高血压、糖尿病、偏头痛和听力损失行单因素方差分析,并采用Logistic回归分析探讨其复发因素。结果①1119例BPPV发病患者,其中男性401例(35.8%),女性718例(64.2%),平均发病年龄(55.0±15.7)岁。②1~12月份全年均可发病,月份/年发病例数最高是12月份(14.4%),最低是4月份(4.7%),相关性有统计学差异(P<0.05),复发例数最高是12月份(21.3%),最低是3月份(4.7%),相关性无统计学差异(P>0.05)。③高血压、糖尿病、偏头痛在老年组和非老年组间BPPV发病有统计学差异(P<0.05),是否存在听力损失在两组间发病无统计学差异(P>0.05)。④随访12个月内,老年组复发率(34.2%)高于非老年组(28.1%),两组间有统计学差异(P<0.05)。⑤高血压或糖尿病是BPPV复发的独立影响因素。结论BPPV发病存在月份相关性,高血压或糖尿病是BPPV复发的独立影响因素,对患有高血压、糖尿病和偏头痛的老年人更应注重预防和宣教。Objective To report clinical features of Benign Paroxysmal Positional Vertigo(BPPV)and factors potentially influencing its occurrence and recurrence as basis for improvement in its clinical prevention and treatment.Methods Demographic data and medical history in 1,119 patients with BPPV diagnosed at the Neurological Vertigo Center of Zhejiang Hospital and treated with instrument repositioning from January 2019 to December 2020 were retrospectively analyzed.In addition,patients were followed for recurrence.Spearman rank correlation analysis was used to determine the relationship between BPPV incidence/recurrence and time of the year.The patients were divided into two groups based on age≥60 years or younger.Single vaiable analysis was performed on hypertension,diabetes,migraine and hearing loss,and logistic regression analysis was used to identify factors associated with recurrence.Results There were 401 males(35.8%)and 718 females(64.2%),aged 55.0±15.7 years.Disease occurrence spread throughout the year,with the highest incidence in December(14.4%)and the lowest incidence in April(4.7%)(P<0.05).The highest rate of recurrence was in December(21.3%)and the lowest in March(4.7%)(P>0.05).③The incidence of BPPV was higher in those older than 60 than those younger(P<0.05),regardless of hypertension,diabetes or migraine and with no significant difference in the incidence of hearing loss between the two groups(P>0.05).At 12 months follow-up,the rate recurrence in patients older than 60(34.2%)was higher than in those younger than 60(28.1%)(P<0.05).Hypertension and diabetes were independent risk factors for recurrence.Conclusion Incidence of BPPV is correlated to months of the year.Hypertension and diabetes are independent influencing factors on BPPV recurrence.For elderly patients with hypertension,diabetes or migraine,attention must be paid to prevention and patient education.

关 键 词：良性阵发性位置性眩晕 发病特点 复发 影响因素 

分 类 号：R764[医药卫生—耳鼻咽喉科]