BPPV诊断中VNG的应用及发病风险模型的构建

The application of VNG in the diagnosis of BPPV and the construction of a disease risk model

目的探讨良性阵发性位置性眩晕(BPPV)诊断中视频眼震电图(VNG)的应用及构建发病风险模型。方法选取BPPV患者64例,均给与VNG及裸眼检查,比较两种检查方式的VNG检出率。将患者分为原发性组(n=52例)和继发性组(n=12例),问卷调查患者性别、年龄、家族疾病史、既往疾病史,进行相关听力学、头部、椎动脉和颈椎影像学检查;Logistic回归分析构建BPPV发病风险模型。结果后半规管型、前半规管型、水平半规管型BPPV的VNG检出率均高于裸眼检出率(P<0.05)。继发性组过度疲劳、合并中耳疾病、全身疾病、脑力和体力劳动、精神和心理因素患者占比均高于原发性组(P<0.05)。Logistics回归分析构建BPPV发病风险的影响因素为过度疲劳、合并中耳疾病、脑力和体力劳动、精神和心理因素(P<0.05)。结论VNG对前、后、水平半规管型BPPV诊断准确性高于裸眼检查,需结合过度疲劳、合并中耳疾病、脑力和体力劳动、精神和心理因素等BPPV发病影响因素来进行综合判断。

Aim To explore the application of video electronystagmography(VNG)in the diagnosis of benign paroxysmal positional vertigo(BPPV)and to construct a disease risk model.Methods 64 patients with BPPV were selected,and VNG and naked eye examinations were performed to compare the detection rates of the two examination methods.The patients were divided into a primary group(n=52)and a secondary group(n=12).A questionnaire survey about the patient s gender,age,family genetic history,and past disease history was conducted,and relevant audiological,head,vertebral artery,and cervical imaging examinations were done.Logistic regression analysis was used to construct a risk model for the onset of BPPV.Results The VNG detection rate of posterior semicircular canal type,anterior semicircular canal type,and horizontal semicircular canal type BPPV was higher than that of naked eye type(P<0.05).The proportion of patients with excessive fatigue,concomitant middle ear diseases,systemic diseases,mental and physical labor,mental and psychological factors in the secondary group was higher than that in the primary group(P<0.05).The influencing factors of BPPV incidence risk constructed by Logistic regression analysis were excessive fatigue,concomitant middle ear disease,mental and physical labor,and mental and psychological factors(P<0.05).Conclusion VNG has a higher diagnostic accuracy for anterior,posterior,and horizontal semicircular canal type BPPV compared with naked eye examination.It is necessary to combine factors such as excessive fatigue,concomitant middle ear disease,mental and physical labor,mental and psychological factors that affect the onset of BPPV for comprehensive judgment.