梅尼埃病患者眩晕程度主观评价的量化分析及其影响因素

A Quantitative Analysis of Subjective Evaluation on Vertigo Degree of Meniere's Disease Patients and Influencing Factors

目的 探讨梅尼埃病患者眩晕程度主观评价方法和影响眩晕症状主观感受的相关因素。方法 对2012年9月~2014年9月就诊的95例急性发作期梅尼埃病患者进行眩晕残障程度评定量表（dizziness handicap inventory,DHI）评分,其中男38例,女57例,平均年龄53.37±14.08岁,平均病程38.74±67.54个月,左耳60例,右耳35例;比较不同性别、年龄、患耳之间DHI总分及功能性（F）、躯体性（P）和情感性（E）障碍各方面得分之间的相关性,并采用多元线性回归分析不同病程（X1）、不同发作频率（X2）、平均听阈（X3）及其双温试验（X4）对DHI评分的影响。结果 195例患者中性别（t=0.838,P=0.404）、耳别（t=0.192,P=0.848）、年龄（t=0.511,P=0.602）对DHI评分的影响无统计学意义;2DHI总评分显示：轻度障碍（0~30分）10例（10.53%）,中度障碍（31~60分）68例（71.58%）,重度障碍（61~100分）17例（17.89%）;F、P、E三方面评分之间存在明显的正相关性,F与E相关性最强;3影响因素多元线性回归分析,得到回归方程Y=32.722＋0.057x_1＋1.334x_2＋0.229x_3,其中双温试验（X4）对DHI评分的影响无统计学意义,发作频率（X2）对DHI评分的影响最大;发作频率〉4次/月组的DHI评分与1次/月、2~4次/月组之间的评分（F=4.725,P=0.011）差异有统计学意义,1次/月和2~4次/月组之间（t=3.00,P=0.730）差异无统计学意义。结论 梅尼埃病患者年龄、性别、耳别、双温试验对DHI评分均无影响,而发作频率、病程、平均听阈是影响评分的重要因素,发作越频繁患者的眩晕主观感觉越重。

Objective To explore influencing factors of the subjective evaluation of vertigo degrees of Meniere＇s disease. Methods The dizziness handicap inventory was used to quantify the vertigo degree of 95 patients with Meniere＇s disease diagnosed at the Zhuhai people＇s hospital from September 2012 to September 2014. The DHI scores and their subgroups in functional （F）, physical （P） and emotional （E） were compared. The multiple linear regression was used to analyze the impact of different duration （X1）, frequency （X2）, average threshold （X3）, and vestibular caloric test （X4） on the DHI scores. Results In 95 patients, males and females were 38 and 57 respec- tively with the average age 53.37 ± 14.08. The duration was 38.74 ± 67.54 months. The left ears were 60 and right were of 35. There was not significant difference in the DHI scores of gender （t=0. 838, P=0. 838）, ear （t= 0. 192, P=0. 192） and age （t=0. 511, P=0. 511） . The total DHI scores were that 10 cases were mild disabilities （10.5%）, 68 moderate （71.60%） and 17 serious obstacle （17.9%）. The F, P and E had obvious positive correla- tions, and the strongest correlation between E and F. The multiple linear regression equation was Y= 32. 722＋O. 057xl 4-1. 334x2 ＋0. 229xs, and frequency influenced DHI scores most. There was statistical difference between the DHI scores of groups of frequency 4 times/month and 1 time/month, and those of groups of frequency 4 times/month and 2--4 times/month （F= 4. 725, P=0. 011）, but no statistical difference exists between those of groups of 1 time/month and 2-4 times/month （t=3.00, P=3.00）. Conclusion The ages, genders, ear sides, and vestibular caloric tests have no significant effects on the DHI scores, while attack frequency, duration, and av- erage thresholds are important factors in evaluations, especially the frequency. The more frequently is the attack, the heavier subjective symptom of vertigo suffers patients with vertigo subjective feeling.