与良性阵发性位置性眩晕相关的影响因素分析

Analysis of influencing factors related to benign paroxysmal positional vertigo

目的探讨良性阵发性位置性眩晕(BPPV)相关的影响因素。方法选取2018年9月至2020年9月于该院神经内科就诊的BPPV患者126例作为BPPV组,选取同期年龄、性别相匹配的70例体检健康者作为对照组。记录两组人群的性别、年龄、饮酒史、吸烟史、糖尿病、高血压、家族冠心病史、偏头痛病史。检测白细胞计数(WBC)、血小板(Plt)、血红蛋白(Hb)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)、肌酐(Cr)、钙离子(Ca^(2+))、无机磷水平;检测血清中单胺类神经递质及其代谢物包括去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)、高香草酸(HVA)、3-甲氧基-4-羟基苯乙醇(MHPG)、5-羟吲哚醋酸(5-HIAA)和3,4-双羟苯乙酸(DOPAC)水平。探讨各指标与BPPV发病的关系。结果与对照组比较,BPPV组糖尿病发生率较高,血清Ca^(2+)、无机磷、DA、NE、5-HT、DOPAC、MHPG、5-HIAA水平降低(P<0.05),HVA水平升高(P<0.05);多因素Logistic回归分析结果显示,糖尿病、Ca^(2+)、无机磷、NE、DA、5-HT是BPPV发生的影响因素。受试者工作特征曲线结果显示,Ca^(2+)<1.89 mmol/L,DA<29.35 mg/L,5-HT<119.4 mg/L对BPPV的预测价值较高。结论BPPV患者血清单胺类神经递质及钙磷代谢水平低于体检健康者,Ca^(2+)、DA、5-HT与BPPV的发病情况有关。

Objective To investigate the influencing factors related to benign paroxysmal positional vertigo(BPPV).Methods A total of 126 BPPV patients who visited the department of Neurology in our hospital from September 2018 to September 2020 were collected as the BPPV group,and 70 cases of age-and gender-matched healthy people were selected as the control group.The gender,age,drinking history,smoking history,diabetes mellitus,hypertension,family history of coronary heart disease and migraine were recorded in the two groups.The levels of leukocyte count(WBC),platelet(Plt),hemoglobin(Hb),triacylglycerol(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),creatinine(Cr),calcium ion(Ca^(2+))and inorganic phosphorus were measured.The levels of monoamine neurotransmitters and their metabolites in serum,including norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT),homovanillic acid(HVA),3-methoxy-4-hydroxyphenylethanol(MHPG),5-hydroxyindole acetic acid(5-HIAA)and 3,4-dihydroxyphenylacetic acid(DOPAC)were detected.The relationship between each index and the incidence of BPPV was explored.Results Compared with the control group,the incidence of diabetes was higher in the BPPV group,the levels of serum Ca^(2+),phosphorus,DA,NE,5-HT,DOPAC,MHPG,5-HIAA were decreased(P<0.05),and the levels of HVA were increased(P<0.05).Multivariate Logistic regression analysis showed that diabetes,Ca^(2+),inorganic phosphorus,NE,DA and 5-HT were the influencing factors of BPPV.The receiver operating characteristic curve results showed that Ca^(2+)<1.89 mmol/L,DA<29.35 mg/L and 5-HT<119.4 mg/L had higher predictive value for BPPV.Conclusion The serum levels of monoamine neurotransmitters and calcium and phosphorus metabolism in BPPV patients are lower than those in healthy people,and Ca^(2+),DA,5-HT are related to the incidence of BPPV.