持续性姿势-感知性头晕患者的临床特点分析  

Analysis of Clinical Characteristics of Patients with Persistent Postural-Perceptual Dizziness

作　　者：邹双骏 安红贤 ZOU Shuangjun;AN Hongxian(Department of Neurology,Tangshan Central Hospital,Tangshan,Hebei 063000,China;Department of Gastroenterology,Tangshan Central Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山中心医院神经内科,河北唐山063000 [2]唐山中心医院消化内科,河北唐山063000

出　　处：《临床误诊误治》2025年第9期61-65,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省2021年度医学科学研究课题(20211633)。

摘　　要：目的 探究持续性姿势-感知性头晕(PPPD)患者的临床特点。方法 回顾性分析2020年1月至2024年4月收治的81例PPPD患者的临床资料,同时选取同期健康体检者50例作为对照组,分析PPPD患者的临床表现,对比2组临床资料、头晕障碍量表(DHI)、医院焦虑抑郁量表(HADS)、贝克抑郁量表(BDI)、状态-特质焦虑问卷(STAI)得分情况,采用多因素logistic回归分析PPPD发生的危险因素。结果 在81例PPPD患者中,主要临床表现为头晕53例(65.43%)、站立不稳36例(44.44%)、非旋转性眩晕31例(38.27%);其中共有59例(72.84%)有可识别的诱因,包括前庭神经炎22例(37.29%)、前庭性偏头痛15例(25.42%)、良性阵发性位置性眩晕8例(13.56%)。PPPD组DHI、HADS、BDI、STAI量表得分均高于对照组(P<0.01)。多因素logistic回归分析结果显示,年龄、女性、合并高血压病、合并颈动脉粥样硬化及同型半胱氨酸(Hcy)是PPPD发生的潜在危险因素。结论 中年女性是PPPD高发人群,年龄、性别、合并高血压病、合并颈动脉粥样硬化及Hcy均为影响疾病发生的危险因素。Objective To investigate the clinical characteristics of patients with persistent postural-perceptual dizziness(PPPD).Methods The clinical data of 81 patients with PPPD admitted from January 2020 to April 2024 were retrospectively analyzed,and 50 healthy physical examinees during the same period were selected as control group,to analyze the clinical manifestations of PPPD patients.The clinical data,Dizziness Handicap Inventory(DHI),Hospital Anxiety and Depression Scale(HADS),Baker Depression Inventory(BDI) and State-trait Anxiety Inventory(STAI) scores of the two groups were compared,and the risk factors of PPPD were analyzed by multivariate Logistic regression.Results Among 81 patients with PPPD,the main clinical manifestations were dizziness(n=53,65.43%),unsteadiness(n=36,44.44%) and non-rotational vertigo(n=31,38.27%).A total of 59 patients(72.84%) had identifiable causes,including vestibular neuritis(n=22,37.29%),vestibular migraine(n=15,25.42%),and benign paroxysmal positional vertigo(n=8,13.56%).The scores of DHI,HADS,BDI and STAI in the PPPD group were higher than those in the control group(P<0.01).Multivariate logistic regression analysis showed that age,female,combined hypertension,combined carotid atherosclerosis and homocysteine(Hcy) were potential risk factors for PPPD.Conclusion Middle-aged female population is a group with high incidence of PPPD.Age,gender,combined hypertension,combined carotid atherosclerosis and Hcy are all risk factors affecting the occurrence of PPPD.

关 键 词：持续性姿势-感知性头晕 头晕障碍量表 状态-特质焦虑问卷 年龄 高血压 颈动脉粥样硬化 同型半胱氨酸 危险因素 

分 类 号：R741[医药卫生—神经病学与精神病学]