老老年良性阵发性位置性眩晕患者的临床特征分析

Clinical characteristics of benign paroxysmal positional vertigo in the oldest old

目的:分析老老年良性阵发性位置性眩晕(BPPV)患者的临床特征。方法:本研究为横断面研究。收集2019年1月至2021年10月就诊于北京天坛医院眩晕诊疗中心的老年BPPV患者,根据年龄分为年轻老年组(60~74岁)和老老年组(≥75岁)。收集相关数据库中BPPV诊断明确、结构性问诊信息完整的BPPV老年患者的临床资料,包括性别、年龄、首次出现头晕/眩晕症状至确诊时间、头晕/眩晕性质、伴随症状、头晕/眩晕诱因和既往史等,并进行组间比较。结果:共纳入老年BPPV患者3019例,其中老老年组415例,年龄(79.54±3.62)岁,年轻老年组2604例,年龄(65.59±3.88)岁。老老年组患者主诉眩晕和诱因为头位或体位变化者的比例均低于年轻老年组(P值分别为0.001和0.003)。而老老年组患者头晕/眩晕的性质为其他(无法判断头晕/眩晕的性质,或无眩晕、平衡障碍或不稳等典型症状)者的比例高于年轻老年组(P=0.002)。老老年组患者头位或体位变化时可诱发眩晕患者的比例亦低于年轻老年组(P=0.001)。与年轻老年组比较,老老年组患者有头痛、自主神经功能紊乱症状的比例较低(均P<0.05),双侧听力下降者的比例较高(P=0.003)。纳入的患者中共1137例可明确首次出现头晕/眩晕症状至确诊时间,其中年轻老年组1004例,老老年组133例,老老年组患者首次出现头晕/眩晕症状至确诊时间>7 d者的比例高于年轻老年组(P<0.05)。结论:相较于年轻老年患者,老老年BPPV患者的临床特征更为不典型。

Objective To analyze the clinical characteristics of benign paroxysmal positional vertigo(BPPV)in the oldest old.Method The clinical data of elderly patients(≥60 years old)with BPPV diagnosed in the Clinical Center for Vertigo and Balance Disturbance of Capital Medical University between January 2019 and October 2021 was collected,including basic information,clinical symptoms in a structured medical history questionnaire and the time interval from the appearance of symptoms to medical consultation.According to the age,patients were divided into elderly group(60-74 years old)and the oldest old group(≥75 years old),and the demographic information,clinical symptoms and consultation time were compared between the two groups.Results A total of 3019 patients with BPPV were included in analysis;there were 415 patients in the oldest-old group with the age of(79.54±3.62)years,and 2604 patients in the elderly group with the age of(65.59±3.88)years.The incidence of vertigo,dizziness or vertigo triggered by position changes of head or body,headache and autonomic symptoms in the eldest-old group were less common than that in the elderly group(all P<0.05).But hearing loss and other types of dizziness(unable to determine the nature of dizziness or vertigo,or without typical symptoms such as dizziness,balance disorders,or instability)were more common in the eldest-old group than those in the elderly group(all P<0.05).Among 3019 patients,1137 had definite time from symptom onset to diagnosis(1004 in the elderly group and 133 in the oldest-old group),the proportion of patients with the time from the onset to diagnosis>7 days in the oldest-old group was higher than that in the elderly group(P<0.05).Conclusion The oldest old patients with BPPV have more atypical symptoms than the younger elderly patients.