摘要
目的 总结良性阵发性位置性眩晕(Benign paroxysmal positional vertigo,BPPV)患者的临床特点,分析耳石复位后残余症状的可能影响因素.方法 回顾分析2020年10月-2023年9月于许昌市立医院神经内科及眩晕门诊就诊,经诊疗仪器确诊并耳石复位的801例患者,记录患者一般人口学信息及病历分析,追踪复诊情况,对最终经仪器确定耳石复位成功的402例患者进行有无残余症状分组,分析年龄,性别,发病时间,耳石复位频次及是否辅助用药,有无高血压病、糖尿病、偏头痛、失眠、耳石复发、脑梗死、冠心病对残余症状的影响.结果 ①801例BPPV患者女570例(71.16％),男231例(28.84％);发病年龄13-89岁,平均年龄(53.72±14.69)岁.病程数小时至数十天不等,平均(7.42±11.57)d;②从年龄分层看,51～60岁组发病率最高31.84％(255例),61-70岁组次之21.22％(170例),≤20岁组最低1.37％(11例);③801例BP-PV 患者单纯后管耳石型占比最高56.55％(453例),其次为单纯水平管耳石型28.46％(228例),多管、复杂耳石型最少2.51％(20例);④采用x2或t检验比较有无残余症状2组患者的年龄,性别,发病时间,耳石复位频次,辅助用药及是否耳石复发,有无高血压病、糖尿病、偏头痛、失眠、冠心病、脑梗死均有明显差异(P＜0.05);⑤对2组患者有无残余症状进行单因素分析后选取有意义自变量(P＜0.05)进行多因素分析发现年龄、发病时间、耳石复位2次及以上为残余症状的独立危险因素(P＜0.05).结论 年龄、发病时间、耳石复位2次及以上为残余症状的独立危险因素,故而及早确诊BPPV及正确复位对于患者尤其是老年人尤为重要.
Abstract
Objective To report the clinical features of patients with Benign Paroxysmal Positional Ver-tigo,and analyze the possible influences on residual symptoms after otolith repositioning.Methods A retro-spective analysis was made on the 801 patients who attending our neurology and vertigo clinic from October 2020 to September 2023 and diagnosed and treated by equipment.General demographic information of the pa-tients was recorded and their medical records were analyzed,follow-up visits were made,and the 402 patients instrumentally determined success of otolith repositioning were grouped according to whether they have residu-al symptoms or not.Single factor analysis and multifactor analysis were performed on age,gender,time of on-set,frequency of otolith repositioning and the presence of adjunctive medication,the presence of hypertension,diabetes mellitus,migraine,insomnia,otolith recurrence,cerebral infarction,and coronary artery disease on residual symptoms-Results ① Of the 801 cases,there were 570(71.16％)female and 231(28.84％)male patients with BPPV.The age of onset ranged from 13 to 89 years,with a mean age of(53.72±14.69)years.The time of onset ranged from a few hours to tens of days,with a mean of(7.42±11.57)days.(2)In terms of age stratification,the highest prevalence rate was 31.84％(255 cases)in the 51-60 year old group,fol-lowed by 21.22％(170 cases)in the 61-70 year old group,and the lowest 1.37％(11 cases)in the ≤20year old group.③ The highest percentage of 801 patients with BPPV was 56.55％(453 cases)with simple posteri-or tubule otolith,followed by 28.46％(228 cases)with simple horizontal tubule otolith,and the least number of patients with multitube and complex otolith was 2.51％(20 cases).④ Chi-square test and T test were per-formed to compare the 2 groups of patients on age,gender,onset time,frequency of otolith repositioning,ad-juvant medication and whether otolith recurrence,the presence or absence of hypertension,diabetes mellitus,migraine,insomnia,coronary artery disease,cerebral infarction.There were dramatic Statistical significance(P＜0.05).⑤ After a univariate analysis of the two groups,a multivariate analysis was performed by selec-ting a meaningful independent variable(P＜0.05).Age,time of onset of disease,and otolith repositioning for 2 or more times were found to be independent risk factors for residual symptoms(P＜0.05).Conclusion Age,time of onset,and two or more otolith repositionings are independent risk factors for residual symptoms,so early diagnosis of BPPV and correct repositioning are especially important for patients,especially the elderly.
维普
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