寰枢关节间隙在颈性眩晕预测评估中的临床应用

Clinical application of axial joint space in prediction and evaluation of cervical vertigo

目的：探讨寰枢关节间隙在颈性眩晕（CV）预测评估中的价值。方法选取2011年5月至2015年3月收治的45例 CV 患者作为观察组，另选取同期45例健康体检者作为对照组，采用三维 CT 测量两组患者寰枢关节间隙，包括寰齿前间隙（ADI）、寰齿突侧块间隙（LADI）及双侧齿突侧块间隙差值（VBLADI）的差异，采用 CV 症状和功能评估量表评估观察组患者治疗前和治疗3周后寰枢关节间隙指标、CV 症状和功能评分的差异，并进行相关性分析。结果两组 ADI、VBLADI 比较差异均有统计学意义（t ＝3．430、87．753，均 P ＜0．05）。观察组治疗后眩晕、颈肩痛、头痛、日常生活、工作心理、社会适应能力评分以及 ADI、VBLADI寰枢关节间隙明显下降（t ＝67．236、31．795、25．198、18．494、19．180、98．194、10．972、75．895，均 P ＜0．05）；相关性分析显示，ADI、VBLADI 与 CV 症状和功能各指标评分呈正相关（r ＝0．456、0．829、0．578、0．456、0．378，均 P ＜0．05；r ＝0．512、0．398、0．782、0．412、0．477、0．891，均 P ＜0．05）。结论寰枢关节病变是 CV 发病的重要因素，寰枢关节间隙与 CV 存在显著相关性，可作为 CV 患者病情评估及治疗的预测指标。

Objective To explore the value of the joint space in the prediction and evaluation of cervical vertigo（CV）.Methods 45 CV patients were selected in our hospital from May 2011 to March 2015 as the observation group,and 45 healthy people in our hospital were selected as control group in the same period.The differences of atlas axis joint space including the atlantodental interval（ADI）,LADI and VBLADI between the two groups were measuredby three dimensional CT,evaluated the difference of indexes of joint space,CV symptom and function score of patients in observation group before treatment and 3 weeks after treatment were observed by CV symptom and function assess-ment scale,and analyzed theirs correlation.Results The differences of ADI and VBLADI between the two groups were statistically significant（t =3.430,87.753,all P 〈0.05 ）.The vertigo,neck pain,headache,daily life and psychological of work and social adaptive capacity scores,ADI and VBLADI levels in the observation group were significantly decreased after treatment（t =67.236,31.795,25.198,18.494,19.180,98.194,10.972,75.895,all P 〈0.05）.Correlation analysis showed that the ADI,VBLADI and the indexes scores of CV symptoms and function were positively correlated（r =0.456,0.829,0.578,0.456,0.378,all P 〈0.05;r =0.512,0.398,0.782,0.412, 0.477,0.891,all P 〈0.05）.Conclusion Axial joint disease is an important factor in the pathogenesis of CV,and there is a significant correlation between the axial joint space and CV,which can be used as a predictive index for the assessment and treatment of patients with CV.