血浆内皮素和降钙素基因相关肽测定在颈性眩晕诊断和治疗评估中的意义

Significance of plasma endothelin and calcitonin gene-related peptide in diagnosis and treatment of cervical vertigo

目的 检测颈性眩晕患者血浆内皮素(ET)和降钙素基因相关肽(CGRP)水平,分析其在诊断和治疗评估中的意义。方法 选取济南市第四人民医院2017年9月至2019年9月收治的颈性眩晕患者33例为观察组,选取同一时间段内33名健康人群为对照组。观察组患者进行颈前路手术治疗,于对照组体检时和观察组术前、术后2、6、12及24周测定其血浆ET和CGRP,并进行比较。分析ET和CGRP与《头晕残障量表》(DHI评分)及《颈性眩晕症状与功能疗效评价表》(眩晕评分)的相关性。结果 术前,观察组患者的血浆ET高于对照组(P<0.05),CGRP水平低于对照组(P<0.05)。术后2、6、12及24周,观察组患者的ET水平明显下降,逐渐接近正常值,但均高于对照组;CGRP水平明显升高,但均低于对照组(P<0.05)。与术前相比,观察组患者的DHI评分明显下降(P<0.01),眩晕评分明显升高(P<0.01)。Pearson相关性分析显示,DHI评分与ET成正相关(r=0.981,P=0.003),与CGRP成负相关(r=-0.898,P=0.038);眩晕评分与ET成负相关(r=-0.991,P=0.001),与CGRP成正相关(r=0.927,P=0.023)。单因素分析与广义相加混合模型分析表明,ET和CGRP与DHI评分以及眩晕评分有着密切的独立作用关系(P<0.05)。结论 ET和CGRP测定在颈性眩晕诊断和治疗评估中具有重要的价值,不仅能用于诊断颈性眩晕,还能用于评估颈性眩晕的疗效。

Objective To detect the levels of plasma endothelin(ET) and calcitonin gene-related peptide(CGRP) in patients with cervical vertigo to analyze their significance in diagnosis and treatment evaluation.Methods Thirty-three patients with cervical vertigo admitted to the Fourth People’s Hospital of Jinan from September 2017 to September 2019 were selected as observation group,and 33 healthy people in the same time period were served as control group.The anterior cervical surgery was performed in observation group.The plasma ET and CGRP were measured in control group at the time of physical examination,and in observation group before,2,6,12 and 24 weeks after operation,and compared.The associations of ET and CGRP with dizziness handicap inventory(DHI) scale and cervical vertigo symptoms and functional scores(vertigo score) were analyzed.Results Before surgery,the plasma ET level in observation group was higher than that in control group(P<0.05),and the CGRP level was significantly lower than that in control group(P<0.05).At 2-,6-,12-and 24-weeks after operation,ET levels in observation group decreased significantly and gradually approached the normal value,but they were still higher than those in control group;CGRP levels were significantly higher,but they were statistically lower than those in control group(P<0.05).Compared with those before operation,DHI score significantly decreased,and vertigo score increased in observation group(P<0.01).Pearson correlation analysis showed that DHI score was positively correlated with ET(r=0.981,P=0.003) and negatively correlated with CGRP(r=-0.898,P=0.038);vertigo score was negatively correlated with ET(r=-0.991,P=0.001) and positively correlated with CGRP(r=0.927,P=0.023).Univariate analysis and generalized additive mixed model analysis showed that ET and CGRP had a close independent relationship with DHI score and vertigo score(P<0.05).Conclusion The determination of ET and CGRP have the important value in the diagnosis and treatment evaluation of cervical vertigo.