良性阵发性位置性眩晕与合并疾病的关联性分析

Correlation analysis between benign paroxysmal positional vertigo and associated comorbidities

目的探讨良性阵发性位置性眩晕(BPPV)的发病病因及风险因素。方法回顾性分析耳鼻喉头颈外科2017年6月至2018年5月的450例BPPV病例的发病情况、明确病因(突聋、头外伤、前庭神经炎、前庭性偏头痛等)及可能的风险因素(高血压、糖尿病、颈椎病、冠心病等相关疾病),并进行分析统计比较。结果BPPV患者的平均年龄为(55.52±13.89)岁、男女比例为1:2.21。无合并疾病的患者共有159例,占比35.33%。合并疾病及风险因素的患者共有291例,占比64.67%,其中明确病因包括突聋、头外伤、前庭神经炎、前庭性偏头痛患者共有78例(17.33%),具有相关疾病患者共有253例(56.22%),其中高血压和糖尿病为最多见的合并疾病,分别占比32.44%和11.56%,但根据二元logistic分析仅有颈椎病与BPPV的发生具有显著的关联性。结论 64.67%的BPPV的患者具有明确病因及风险因素,多数BPPV患者是继发性BPPV;患者耳石复位后,部分患者病理损伤仍然存在,因此BPPV综合治疗及预防复发还要关注相关疾病和风险因素的干预。

Objective To investigate the etiology and risk factors of benign paroxysmal positional vertigo(BPPV).Methods We retrospectively analyzed and statistically compared the incidence,etiology,and possible risk factors in450 cases of BPPV in the Department of Otolaryngology Head and Neck Surgery at our hospital from2017.Results The average age of BPPV patients was55.52±13.89 years,and the ratio of males to females was1∶2.21.Of these cases,159 patients(35.33%)did not have any comorbidities,while291 patients(64.67%)presented with associated comorbidities.Among them,78(17.33%)patients presented with a clear cause such as idiopathic sudden hearing loss,head trauma,vestibular neuritis,or vestibular migraine.A total of253(56.22%)patients had associated risk factors such as hypertension,diabetes mellitus,cervical spondylosis,and coronary heart disease.Hypertension and diabetes were the most common comorbidities present in the group,accounting for32.44%and11.56%,respectively.However,using binary logistic analysis,only cervical spondylosis appeared to have a significant correlation with the occurrence of BPPV.Conclusion About64.67%of patients presenting with BPPV in this study also had a comorbidity.The majority of patients with BPPV had idiopathic BPPV.After otolith reduction,pathological injury still existed.Treatment of comorbidities should be considered carefully so as to prevent the occurrence and recurrence of BPPV.