神经内科眩晕专病门诊患者病因初步分析

Etiological analysis on patients in department of vertigo and dizziness oriented outpatient

目的总结眩晕专病门诊患者病因分布特点，进一步明确门诊常见眩晕患者病因，以期为眩晕患者的有效诊疗提供参考。方法回顾性分析2012年12月至2015年7月上海长征医院神经内科眩晕专病门诊患者资料，对所有患者按照目前公认的诊断标准进行诊断。结果眩晕专病门诊共诊治各类头晕眩晕患者5348例（排除复诊患者），男女比例1：1．52（男2117例，女3231例），年龄16～93岁。各类头晕眩晕疾病所占比例依次为良性阵发性位置性眩晕1902例（35．56％）、慢性主观性头晕1329例（24．85％）、前庭性偏头痛624例（11．67％）、梅尼埃病378例（7．07％）、多感觉性神经病231例（4．32％）、前庭阵发症177例（3．31％）、良性复发性前庭病171例（3．20％）、晕厥前状态66例（1．23％）、后循环缺血57例（1．07％）、前庭神经炎54例（1．01％）、突聋36例（0．67％）、其他原因68例（1．27％）、原因不明255例（4．77％）。结论眩晕专病门诊患者病因初步分析显示，眩晕专病门诊前3位的病因分别为良性阵发性位置性眩晕、慢性主观性头晕和前庭性偏头痛。其他较为常见的疾病为梅尼埃病、多感觉性神经病、前庭阵发症、良性复发性前庭病。晕厥前状态、后循环缺血、前庭神经炎、突聋伴眩晕相对少见。仍有一定比例患者不能明确诊断。

Objective We aimed to explore the spectrum of causes for patients in department of vertigo and dizziness oriented outpatient, in order to provide a reference for diagnosis and treatment of patients with vertigo or dizziness. Methods Retrospective analysis were carried out with clinical data of patients in our department of vertigo and dizziness oriented outpatient. The target group under study was diagnosed based on the uniform diagnostic criteria, and re-visiting patients were excluded. Results This clinical study was conducted on 5 348 cases, who visited our vertigo and dizziness oriented outpatient from December 2012 to July 2015. The ratio of male to female was 1 ： 1.48, the age range was between 16 and 93. The frequencies of different etiology were： benign paroxysmal positional vertigo 1 902 （35.56%）, Chronic subjective dizziness 1 329 （ 24.85 % ） , vestibular migraine 624 （ 11.67 % ） , Meniere＇ s disease 378 （7.07%）, multi-sensory neuropathy 231 （4. 32% ）, vestibular paroxysmia 177 （ 3.31% ）, benign recurrent vestibulopathy 171 （ 3.20% ）, presyncope 66 （ 1.23% ）, posterior circulation ischemia 57 （ 1.07% ）, vestibular neuritis 54 （1.01%）, sudden deafness complicated vertigo 36 （0. 67% ）, other reasons 68 （ 1.27% ） ,unknown 255 （4.77%）. Conclusions Our study indicates that the precedent three causes for vertigo or dizziness are benign paroxysmal positional vertigo, chronic subjective dizziness and vestibular migraine, followed by Meniere＇ s disease, multi-sensory neuropathy, vestibular paroxysmia and benign recurrent vestibulopathy. Presyncope, posterior circulation isehemia, vestibular neuritis and sudden deafness complicated vertigo are relatively infrequent. There are still a certain proportion of patients undetermined.