不同年龄及职业人群良性阵发性位置性眩晕临床特征分析

Clinical characteristics of benign positional paroxysmal vertigo in different ages and occupations

目的探讨不同年龄及职业良性阵发性位置性眩晕(benign positional paroxysmal vertigo,BPPV)患者的临床特征。方法选取2018年1—12月清华大学附属北京清华长庚医院收治的BPPV成年患者692例,收集患者的人口学资料(性别、年龄、职业)和临床资料,包括患病侧别、临床分型、是否残余症状等,对随访满2年且资料完整者的复位次数、复发情况、残余症状持续时间等特征进行分析。结果692例患者均完成BPPV诊断并配合复位治疗,其中女性(472例)多于男性(220例),≥60岁的老年患者(339例)明显多于20~<45岁和45~<60岁的青中年患者(163例和190例),临床分型中后半规管(57.5%)受累比率高于水平半规管(41.8%)和上半规管(0.7%),差异均有统计学意义(P<0.05)。随访满2年且资料完整的患者共169例(24.4%),老年组的复位次数和残余症状持续时间均多于青年组和中年组[(1.8±1.1)次比(1.3±0.6)次和(1.3±0.4)次,7(2,21)d比2(1,7)d和3(2,14)d],差异均有统计学意义(P<0.05)。77例在职患者中,脑力劳动者人数(59例)多于体力劳动者(18例),差异有统计学意义(P<0.05);与体力劳动组相比,脑力劳动组性别分布不同(女性55.9%比22.2%,男性44.1%比77.8%)、平均年龄较低[(36.6±9.2)岁比(47.4±7.5)岁]、残余症状持续时间较短[2(1,4)]d比[7(2,25)]d,差异均有统计学意义(P<0.05)。结论BPPV多见于老年及女性患者,残余症状持续时间较长,后半规管受累最常见,在职脑力劳动患者人数较多且残余症状持续时间较短。

Objective To explore the clinical characteristics of benign positional paroxysmal vertigo(BPPV)in different ages and occupations.Methods A total of 692 BPPV patients admitted to Beijing Tsinghua Changgung Hospital,Tsinghua University from January to December 2018 were selected.Demographic data including gender,age and occupation,and clinical data including the ratio of disease sides,clinical classification,residual symptoms were collected.The characteristics of reduction times,recurrence and duration of residual symptoms of the patients who had been followed up for two years with complete data were analyzed.Results All the 692 patients completed BPPV diagnosis and cooperated with reduction therapy,of which female(472 cases)were more than male(220 cases),elderly patients over 60 years old(339cases)were significantly more than young patients aged 20-<45 years old(163 cases)and middle-aged patients aged 45-<60 years old(190 cases).The rate of posterior semicircular canal(57.5%)was higher than that of the horizontal semicircular canal(41.8%)and that of the superior semicircular canal(0.7%),the difference was statistically significant(P<0.05).There were 169 patients(24.4%)who had been followed up for two years with complete data.The frequency of reduction[(1.8±1.1)times]and duration of residual symptoms[7(2,21)d]in the elderly group were higher than those in the young group[(1.3±0.6)times,2(1,7)d]and the middle-aged group[(1.3±0.4)times,3(2,14)d],all with statistical significance(P<0.05).Among 77 occupational patients,mental workers(59 cases)were more than manual workers(18 cases),and the differences were statistically significant(P<0.05).Compared with the manual workers,the gender distribution of mental workers(55.9%female and 44.1%male vs.22.2%female and 77.8%male),the average age[(36.6±9.2)years vs.(47.4±7.5)years],and the duration of residual symptoms[2(1,4)d vs.7(2,25)d]were significantly different(P<0.05).Conclusions BPPV is more common in elderly and female patients with longer recovery time,with posterior semicircular canal involvement,and mainly in mental workers with shorter duration of residual symptoms.