老年良性位置性眩晕患者的椎基底动脉血管状态研究

Vertebrobasilar Artery Changes in Senior Patients with Benign Paroxysmal Positional Vertigo

目的分析老年良性位置性眩晕(BPPV)患者椎基底动脉血管异常情况及其与眩晕程度和治疗的关系。方法连续入选2010年6月—2012年4月郑州人民医院神经内科住院的老年(≥65岁)BPPV患者126例作为研究组进行前瞻性研究,并选取本院年龄≥65岁老年无眩晕病史的志愿者88例作为对照组。根据两组患者血管检查结果分为椎动脉异常组、基底动脉异常组和椎基底动脉正常组。重点记录患者椎基底动脉狭窄或闭塞、椎基底动脉弯曲和椎动脉优势等血管异常情况,并进行眩晕级别判断。结果两组的性别构成、年龄、吸烟率、并发症发生率比较,差异无统计学意义(P>0.05)。研究组椎动脉狭窄或闭塞、椎动脉迂曲、椎动脉优势、基底动脉狭窄或闭塞、基底动脉弯曲≥2级、其他异常发生率均高于对照组(P<0.05);研究组椎基底动脉正常发生率低于对照组(P<0.05)。研究组中椎动脉异常亚组、基底动脉异常亚组和椎基底动脉正常亚组患者眩晕级别及治疗缓解时间比较,差异有统计学意义(P<0.05)。椎动脉狭窄或闭塞、椎动脉优势、单侧或双侧椎动脉迂曲均与患者眩晕级别呈正相关(r=0.548、0.612、0.625,P<0.05)。结论老年BPPV患者椎基底动脉异常发生率较高,尤其是椎动脉优势和椎动脉迂曲,可能合并后循环血液供应障碍而影响患者眩晕级别及治疗缓解时间。

Objective To investigate vertebrobasilar artery（ VBA）lesions in senior patients with benign paroxysmal positional vertigo（BPPV）by magnetic resonance angiography（MRA）. Methods From June 2010 to April 2012,in Zheng-zhou Peopleˊs Hospital,elderly BPPV patients（≥65 years old）were enrolled in study group,88 subjects without BPPV in con-trol group. The patients were divided, according to vascular examination results, into subgroups abnormal vertebral artery （ VA）,abnormal basilar artery（ BA）,C with normal VBA. VBA narrowing or occlusion,abnormal curvature,dominance and other vascular anomalies were recording mainly. ResUlts There was no significant difference in gender,age,smoking rate, complication incidence between 2 groups（P 〉0. 05）. The incidences of VA narrowing or occlusion,tortuosity,dominance, BA narrowing or occlusion,circuity grade≥Ⅱand other anomalies were higher,incidence of normal VBA lower in study group than in control group（P 〈0. 05）. In study group,there was difference in dizziness grade,remission time among subgroups VA,BA,VBA（P〈0. 05）. VA narrowing or occlusion,dominance,unilateral or bilateral VA tortuosity were correlated posi-tively with dizziness grades（r =0. 548,0. 612,0. 625,P 〈0. 05）. ConclUsion Elderly BPPV patients have a high inci-dence of VBA abnormality,especially VA dominance,tortuosity,which may be combined with posterior circulation blood supply obstacles to impact patientsˊdizziness grades and remission time.