良性阵发性位置性眩晕复发的影响因素分析

doi:10.3969/j.issn.1674-490X.2023.04.008

摘要/Abstract

摘要： 目的分析良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)患者复发的相关危险因素,对BPPV的复发进行有针对性的预防,提高患者的生活质量。方法调取2018年1月至2019年1月就诊于河北大学附属医院耳鼻咽喉科经明确诊断的255例BPPV患者的病历资料,所有患者均成功完成手法复位治疗,详细记录所有患者性别、年龄、发病次数及既往病史(包括原发性高血压、糖尿病、高脂血症、睡眠质量等),记录所有患者焦虑抑郁量表(Hospital Anxiety and Depression Scale, HADS)评分,评估患者是否存在焦虑或(和)抑郁,并记录患者血清钙离子浓度及血清同型半胱氨酸(homocysteine, HCY)浓度。临床或电话随访1年,记录BPPV患者复发情况,分析比较复发组及非复发组患者基线资料,通过多元线性回归分析BPPV复发的危险因素。结果经严格纳入标准及排除标准后,本研究共纳入255例BPPV患者,所有患者均完成手法复位,临床或电话随访1年,31例患者失访,共224例患者完成随访,其中复发组52例,非复发组172例,复发率为23.21%。经单因素方差分析比较,2组患者性别、年龄、高脂血症、血钙浓度差异无统计学意义(P>0.05),原发性高血压、糖尿病、睡眠质量、焦虑或(和)抑郁、血HCY浓度差异有统计学意义(P<0.05)。再经二元Logistic回归分析显示,焦虑或(和)抑郁是BPPV患者复发的独立危险因素。结论焦虑或(和)抑郁与BPPV复发密切相关。

关键词: 良性阵发性位置性眩晕, 复发, 危险因素

Abstract: Objective To analyze the risk factors associated with recurrence in patients with benign paroxysmal positional vertigo(BPPV)and provide targeted prevention of recurrence of BPPV and improve the quality of life of patients. Methods The medical records of 255 patients with BPPV who were admitted to the Department of Otolaryngology, Affiliated Hospital of Hebei University from January, 2018 to January, 2019 were collected. All patients successfully completed manual reduction treatment. Gender, age, frequency of incidence and previous medical history(including hypertension, diabetes, hyperlipidemia, sleep quality, etc.)of all patients were recorded in detail. All patients' hospital anxiety and depression scale(HADS)scores were recorded to assess whether they had anxiety or(and)depression, and serum calcium ion concentration and serum homocysteine(HCY)concentration were recorded. The recurrence of BPPV patients was recorded in clinical or telephone follow-up for 1 year. The baseline data of patients in the relapsing group and the non-relapsing group were analyzed and compared. The risk factors of BPPV recurrence were analyzed by multiple linear regression. Results After strict inclusion and exclusion criteria, a total of 255 patients with BPPV were included in this study, and all patients completed the manual repositioning and were followed up clinically or by telephone for 1 year, 31 patients were lost, and a total of 224 patients completed the follow-up, including 52 patients in the recurrence group and 172 patients in the non-recurrence group, with a recurrence rate of about 23.2%. By comparing the two groups by one-way ANOVA, the differences were not statistically significant(P>0.05)for gender, age, hyperlipidemia, and blood calcium concentration, and statistically significant(P<0.05)for hypertensive disease, diabetes, sleep quality, anxiety or(and)depression, and blood HCY concentration. Further binary logistic regression analysis revealed that anxiety or(and)depression was an independent risk factor for recurrence in patients with BPPV. Conclusion Anxiety and/or depression are closely related to BPPV recurrence.

Key words: benign paroxysmal positional vertigo, recurrence, risk factors

中图分类号:

徐玉玲,李嘉凯,田从哲,孟峥. 良性阵发性位置性眩晕复发的影响因素分析[J]. 医学研究与教育, 2023, 40(4): 45-52.

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