急性前庭综合征的分类研究

Classification of acute vestibular syndrome

目的:分析急性前庭综合征(AVS)中各种疾病的临床特征和构成,为制定合理的诊断标准及进一步的治疗策略提供参考。方法:回顾性分析77例AVS患者的病历资料(包括姓名、性别、年龄、糖尿病、高血压、眩晕病史及家族史等),神经系统检查和前庭功能检查以及影像学检查等。根据诊断标准进行分类诊断,并分析患者病史信息等数据。结果:77例患者中前庭神经炎34例,突发性聋伴眩晕18例,听神经瘤1例,伴偏头痛的AVS 6例,亨特综合征伴眩晕3例,外伤后眩晕1例,急性双侧前庭病1例,急性迷路炎3例,后循环梗死1例,其他急性眩晕综合征9例。不同病因间年龄、病程差异无统计学意义(P>0.05),前庭神经炎和突发性聋伴眩晕2组之间甩头试验、自发性眼震、耳鸣及听力下降等各指标间差异均有统计学意义(P<0.05)。突发性聋伴眩晕与其他急性眩晕综合征间听力比较差异有统计学意义(P<0.05)。结论:就诊于耳鼻咽喉头颈外科门诊的AVS患者中,多数为周围性AVS,以前庭神经炎、突发性聋伴眩晕为主,伴偏头痛的AVS不在少数,中枢性眩晕也可见。

Objective：To explore the epidemiological characteristics and to help accomplish accurate diagnosis and treatment strategies by analyzing the composition and clinical features of various diseases with acute constant vertigo.Method：We retrospectively analyzed medical records（including name,sex,age,diabetes,hypertension,history of vertigo,family history,etc.）,otoneurological examination,vestibular function tests and radiological examination of patients with acute vestibular syndrome.We classified various diseases according to diagnostic criteria,and then analyze the clinical data.Result：A total of 77 patients with acute vestibular syndrome were enrolled in this study.It included 34 patients with vestibular neuritis,18 patients with sudden sensorineural deafness with vertigo,1 with vestibular schwannoma,6 with acute vestibular syndrome with migraine,3 with Hunter syndrome with vertigo,1 with vertigo after trauma,1 with acute bilateral vestibulopathy,9 with acute vertigo syndrome with other etiology,3 with acute labyrinthitis,and 1 with posterior circulation infarction.There were no significant differences in the age and course of disease between different etiologies（P〈0.05）.There were statistical differences between vestibular neuritis and sudden sensorineural deafness with vertigo among head impulse test and hearing loss（P〉0.05）.There was significant difference in hearing between sudden sensorineural deafness with vertigo and acute vertigo syndrome（P〈0.05）.Conclusion：Most of the acute vestibular syndrome patients attending the otorhinolaryngology head and neck surgery clinic were peripheral acute vestibular syndrome,vestibular neuritis,and sudden sensorineural deafness with vertigo.Patients with acute vestibular syndrome with migraine are not rare,and central vertigo can also be seen.