良性阵发性位置性眩晕合并梅尼埃病的临床特征

Clinical features of patients with coexistence of benign paroxysmal positional vertigo and Meniere's disease

目的分析良性阵发性位置性眩晕(BPPV)合并梅尼埃病病例的临床特征及预后。方法 2009年7月至2011年12月我院神经内科确诊BPPV患者343例,收集上述患者的临床资料,随访6年,通过与同期特发性BPPV病例的比较,分析评价BPPV合并梅尼埃病病例的临床特征及预后情况。结果 343例BPPV患者中特发性BPPV305例,继发于其他病因者26例,合并有梅尼埃病者12例(3.5%)。与特发性BPPV患者相比,BPPV合并梅尼埃病患者的平均年龄为(59.83±6.12)岁,明显大于特发性BPPV患者的(53.99±12.37)岁,t=3.069,P=0.008;其BPPV复发率(83.3%)亦明显高于特发性BPPV的复发率(17.4%),χ~2=27.535,P<0.001;但两组病例性别、平均病程及受累半规管的分布差异均无统计学意义。结论 BPPV合并梅尼埃病的发生率为3.5%,BPPV多发生于梅尼埃病病程的后期,患病年龄相对较大,BPPV更容易出现复发。

Objective To investigate the clinical characteristics and outcome of patients with coexist of benign par- oxysmal positional vertigo （BPPV） and Meniere＇ s disease. Methods A total of 343 cases who were diagnosed with BP- PV in the Department of Neurology, Beijing Tiantan Hospital of Capital Medical University from July 2009 to December 2011 were enrolled. The medical records of patients were reviewed. All the patients were followed up for 6 years to determine the outcomes. The clinical characteristics and outcome of patients with coexist BPPV and Meniere＇ s disease were evaluated. Results Among the 343 patients, 305 cases had idiopathic BPPV, 26 cases had BPPV secondary to other dis- eases, and 12 patients （3.5%） suffered from both BPPV and Meniere＇ s disease. Compared with idiopathic BPPV, patients with coexist BPPV and Meniere＇ s disease were older （t = 3.069, P = 0.008）and had a higher recurrence rate of BPPV （X2= 27.535, P 〈 0.001）, but there were no differences in gender, duration of BPPV （P 〉 0.05） and involved semicircular canals （x2=0.003, P = 0.958） between the two groups. Conclusion Among patients with BPPV, the incidence of Meniere＇ s disease is about 3.5%. BPPV usually occurs in the late stages of Meniere＇ s disease. Patients with both BPPV and Meniere＇ s disease are older and BPPV is more likely to recur in these patients.