神经内科眩晕／头晕患者的病因分析

Etiological analysis on patients with vertigo or dizziness

目的总结眩晕/头晕的病因分布及人口学特征，为其诊治提供参考。 方法收集包头市中心医院2016年1月1日至2017年9月30日以眩晕/头晕为主诉就诊于神经内科急诊、住院部、门诊及眩晕中心的患者资料，分析总结其病因分布。 结果按照纳入排除标准共收集9 200例各类病因的眩晕/头晕患者，男女比例1∶1.8，年龄19～85（53.68±12.46）岁。病因依次为：良性阵发性位置性眩晕3 148例（34.22%）、持续性姿势－知觉性头晕2 006例（21.80%）、脑血管因素导致的眩晕1 463例（15.90%）、前庭神经炎741例（8.05%）、前庭性偏头痛536例（5.83%）、前庭阵发症336例（3.65%）、梅尼埃病187例（2.03%）、药源性眩晕96例（1.04%）、神经系统变性疾病74例（0.80%）、伴有眩晕的突发性耳聋51例（0.55%）、多发性硬化及视神经脊髓炎21例（0.23%）、其他病因22例（0.24%）、病因不明519例（5.64%）。 结论眩晕/头晕为多病因的多学科疾病，最常见的为良性阵发性位置性眩晕，随着年龄的增加脑血管因素导致的头晕比例增加。持续性姿势－知觉性头晕的患者在临床上很常见，临床工作中应该加强认识。

ObjectiveTo explore the spectrum of causes for patients with vertigo or dizziness in the Department of Neurology,and provide a reference for diagnosis and treatment of patients with vertigo or dizziness. MethodsClinical data of patients in the Department of Neurology,Baotou Central Hospital between January 2016 and September 2017 was retrospectively analyzed.The target group under study was diagnosed based on the uniform diagnostic criteria. ResultsA total of 9 200 patients with a chief complaint of vertigo or dizziness were included.The ratio of male to female was 1∶1.8,with an age range of 19 to 85 years.The different etiology was as follows：benign paroxysmal positional vertigo（BPPV）（3 148 cases,34.22%）,persistent postural-perceptual dizziness（PPPD）（2 006 cases,21.80%）,vertigo caused by cerebrovascular diseases（1 463 cases,15.90%）,vestibular neuritis（741 cases,8.05%）,vestibular migraine（536 cases,5.83%）,vestibular paroxysmia（336 cases,3.65%）,Ménière disease（187 cases,2.03%）,drug-induced vertigo（96 cases,1.04%）,neurological degenerative diseases（74 cases,0.80%）,sudden sensorineural hearing loss（51 cases,0.55%）,multiple sclerosis and neuromyelitis optica（21 cases,0.23%）,other reasons（22 cases,0.24%）,unknown reasons（519 cases,5.64%）. ConclusionsDizziness is resulted from various causes,and BPPV is the most common reason.Vertigo caused by cerebrovascular diseases appears to gradually increase along with age.PPPD is very common in clinical practice,so clinicians needs to be highly aware of BPPV and PPPD.Although those dizziness diseases have a low incidence,they should not be ignored.There are still certain proportion of vertigo patients whose diagnosis are undetermined.