应激事件影响下“耳石症”患者的临床调查与分析

Investigation of the patients with positional vertigo during the period of stress events

目的对应激事件时期以眩晕为主诉患者进行临床调查,分析疑似"耳石症"病例的临床特点。方法纳入2020-01-24~2020-03-31在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科就诊的眩晕患者183例作为研究组,以2019-01-24~2019-03-31同期就诊的眩晕患者508例作为对照组进行临床资料对比分析,包括良性阵发性位置性眩晕(BPPV)的筛查率、确诊率、头晕评价量表(Dizziness Handicap Inventory,DHI)、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)评分和匹兹堡睡眠质量指数量表(Pittsburgh Sleepquality Index,PSQI)评价等数据。结果①研究组中因眩晕与位置相关而进行BPPV筛查者占94.0%(172/183),高于对照组65.4%(332/508)(P<0.001)。②研究组中确诊为BPPV患者为16.4%(30/183),高于对照组7.9%(40/508)(χ~2=10.726,P=0.001)。③研究组中BPPV确诊患者DHI总分及各维度评分与对照组间差异无统计学意义(P>0.05);以焦虑情绪为主的患者占63.3%(19/30)较对照组35.0%(14/40)高,差异具有统计学意义(χ~2=5.523,P=0.019);出现睡眠质量下降者占60%(16/30)与对照组65%(26/40)差异无统计学意义(P>0.05)。④对研究组中77例患者进行双温试验,其中37.7%(29/77)正常,与对照组24.6%(52/211)差异有统计学意义(χ~2=4.729,P=0.030)。结论在应激事件影响下疑似"耳石症"患者增加,在临床诊治时应注意有效甄别眩晕患者伴随的情绪认知和睡眠质量问题。

OBJECTIVE To investigate the characteristics of the patients with vertigo during the period of stress event and analyze the data of suspected patients with benign paroxysmal positional vertigo(BPPV).METHODS 183 patients with vertigo from January 24,2020 to March 31,2020 were enrolled in the study as a study group;508 patients with vertigo in the same period in 2019 were enrolled as the control group.The BPPV screening rate,diagnosis rate,Dizziness Handicap Inventory(DHI),Hospital Anxiety and Depression Scale(HADS) and Pittsburgh Sleep Quality Index(PSQI) scale were analyzed.RESULTS1.The screening rate of BPPV in the study group(172/183,94.0%) was higher than that in the control group(332/508,65.4%)(P<0.001).2.The diagnosis rate of BPPV in the study group(30/183,16.4%) was higher than that in the control group(40/508,7.9%)(χ~2=10.726,P=0.001).3.There was no significant difference in the total score of DHI scale and each subscales(P>0.05) between two groups.Patients with anxiety in the study group(19/30,63.3%) were more than those in the control group(14/40,35.0%),the difference was statistically significant(χ~2=5.523,P=0.019).There were about 60.0% of the patients had sleep disorders,and there was no significant difference between the two groups(P>0.05).4.29 patients confirmed normal vestibular function in the study group which was higher than that in the control group(χ~2=4.729,P=0.030).CONCLUSIONPatients with BPPV like symptoms increased during the period of stress event.It is necessary to effectively identify the emotion cognition and sleeping problems in clinical diagnosis and treatment.