良性阵发性位置性眩晕病因学研究

Etiology analysis of benign paroxysmal positional vertigo

目的研究良性阵发性位置性眩晕病的可能病因,并分析其临床特点。方法收集2014年3月至2017年3月我院收治的256例BPPV患者的临床资料。采用多因素Logistic回归分析BPPV发生与各临床参数之间的相关性。结果 BPPV患者多见于50岁以上的女性,以后半规管BPPV为主。约1/3的患者存在耳科疾病史,常合并高血压、糖尿病、骨质疏松、动脉粥样硬化及血脂异常等代谢性疾病;约50%的患者存在负性的心理状态,多吸烟、饮酒。多因素Logistic回归分析显示,头外伤、耳科疾病、高血压、糖尿病、血脂异常、动脉粥样硬化、骨质疏松、吸烟及焦虑是BPPV患病的危险因素(P<0.05或P<0.01)。结论 BPPV以≥50岁的女性患者居多,以后半规管BPPV为主,约1/3的患者有耳科疾病史,半数患者存在负性的心理状态,头外伤、耳科疾病、高血压、糖尿病、血脂异常、动脉粥样硬化、骨质疏松、吸烟及焦虑可能是BPPV患病的危险因素。

Objective To investigate the etiology and characteristics of benign paroxysmal positional vertigo （BP- PV）. Methods The clinical data of 256 patients with BPPV diagnosed and treated in our hospital from March 2014 to March 2017 were collected, and multiple logistic regression analysis was used to examine the association between BPPV and clinical parameters. Results Most BPPV cases were females and were older than 50 years old. Posterior canal BPPV was the most common variant of BPPV. About a third of patients had a history of ear diseases, and patients often suffered from metabolic diseases such as hypertension, diabetes, osteoporosis, atherosclerosis and dyslipidemia. About 50% of the patients had a negative psychological state, and smoking and drinking were common. Multiple logistic regression analysis showed that head injury, ear disease, hypertension, diabetes, osteoporosis, atherosclerosis, dyslipidemia, smoking and anxiety were risk factors for BPPV （P 〈 0.05）. Conclusion The majority of BPPV cases are older than 50 years-old females. The most common variant is posterior canal BPPV. About a third of patients have a history of ear disease, half of patients have a negative psychological state, and the patients often have concurrent metabolic diseases, with smoking and drinking. Head injury, ear disease, hypertension, diabetes, osteoporosis, atherosclerosis, dyslipidemia, smoking and anxiety are the risk factors of BPPV.