[1]李婷婷,葛槟华.801例良性阵发性位置性眩晕患者的临床特点及残余症状影响因素分析[J].卒中与神经疾病杂志,2024,31(05):476-481.[doi:10.3969/j.issn.1007-0478.2024.05.010]
 Li Tingting,Ge Binhua..Clinical features and influences of residual symptom of 801 patients with Benign Paroxysmal Positional Vertigo[J].Stroke and Nervous Diseases,2024,31(05):476-481.[doi:10.3969/j.issn.1007-0478.2024.05.010]
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801例良性阵发性位置性眩晕患者的临床特点及残余症状影响因素分析()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第31卷
期数:
2024年05期
页码:
476-481
栏目:
论著
出版日期:
2024-10-20

文章信息/Info

Title:
Clinical features and influences of residual symptom of 801 patients with Benign Paroxysmal Positional Vertigo
文章编号:
1007-0478(2024)05-0476-06
作者:
李婷婷葛槟华
461000 河南省许昌市立医院神经内科
Author(s):
Li Tingting Ge Binhua.
Department of Neurology, Xuchang Municipal Hospital, Xuchang Henan, 461000
关键词:
良性阵发性位置性眩晕 临床特点 残余症状 影响因素
Keywords:
Benign paroxysmal positional vertigo Clinical features Residual symptom Influences
分类号:
R76
DOI:
10.3969/j.issn.1007-0478.2024.05.010
文献标志码:
A
摘要:
目的 总结良性阵发性位置性眩晕(Benign paroxysmal positional vertigo,BPPV)患者的临床特点,分析耳石复位后残余症状的可能影响因素。方法 回顾分析2020年10月-2023年9月于许昌市立医院神经内科及眩晕门诊就诊,经诊疗仪器确诊并耳石复位的801例患者,记录患者一般人口学信息及病历分析,追踪复诊情况,对最终经仪器确定耳石复位成功的402例患者进行有无残余症状分组,分析年龄,性别,发病时间,耳石复位频次及是否辅助用药,有无高血压病、糖尿病、偏头痛、失眠、耳石复发、脑梗死、冠心病对残余症状的影响。结果 ①801例BPPV患者女570例(71.16%),男231例(28.84%); 发病年龄13~89岁,平均年龄(53.72±14.69)岁。病程数小时至数十天不等,平均(7.42±11.57)d; ②从年龄分层看,51~60岁组发病率最高31.84%(255例),61~70岁组次之21.22%(170例),≤20岁组最低1.37%(11例); ③801例BPPV患者单纯后管耳石型占比最高56.55%(453例),其次为单纯水平管耳石型28.46%(228例),多管、复杂耳石型最少2.51%(20例); ④采用χ2t检验比较有无残余症状2组患者的年龄,性别,发病时间,耳石复位频次,辅助用药及是否耳石复发,有无高血压病、糖尿病、偏头痛、失眠、冠心病、脑梗死均有明显差异(P<0.05); ⑤对2组患者有无残余症状进行单因素分析后选取有意义自变量(P<0.05)进行多因素分析发现年龄、发病时间、耳石复位2次及以上为残余症状的独立危险因素(P<0.05)。结论 年龄、发病时间、耳石复位2次及以上为残余症状的独立危险因素,故而及早确诊BPPV及正确复位对于患者尤其是老年人尤为重要。
Abstract:
ObjectiveTo report the clinical features of patients with Benign Paroxysmal Positional Vertigo, and analyze the possible influences on residual symptoms after otolith repositioning.Methods A retrospective analysis was made on the 801 patients who attending our neurology and vertigo clinic from October 2020 to September 2023 and diagnosed and treated by equipment. General demographic information of the patients was recorded and their medical records were analyzed, follow-up visits were made, and the 402 patients instrumentally determined success of otolith repositioning were grouped according to whether they have residual symptoms or not. Single factor analysis and multifactor analysis were performed on age, gender, time of onset, frequency of otolith repositioning and the presence of adjunctive medication, the presence of hypertension, diabetes mellitus, migraine, insomnia, otolith recurrence, cerebral infarction, and coronary artery disease on residual symptoms.Results ① Of the 801 cases, there were 570(71.16%)female and 231(28.84%)male patients with BPPV. The age of onset ranged from 13 to 89 years, with a mean age of(53.72±14.69)years. The time of onset ranged from a few hours to tens of days, with a mean of(7.42±11.57)days. ② In terms of age stratification, the highest prevalence rate was 31.84%(255 cases)in the 51-60 year old group, followed by 21.22%(170 cases)in the 61-70 year old group, and the lowest 1.37%(11 cases)in the ≤20 year old group. ③ The highest percentage of 801 patients with BPPV was 56.55%(453 cases)with simple posterior tubule otolith, followed by 28.46%(228 cases)with simple horizontal tubule otolith, and the least number of patients with multitube and complex otolith was 2.51%(20 cases). ④ Chi-square test and T test were performed to compare the 2 groups of patients on age, gender, onset time, frequency of otolith repositioning, adjuvant medication and whether otolith recurrence, the presence or absence of hypertension, diabetes mellitus, migraine, insomnia, coronary artery disease, cerebral infarction. There were dramatic Statistical significance(P<0.05). ⑤ After a univariate analysis of the two groups, a multivariate analysis was performed by selecting a meaningful independent variable(P<0.05). Age, time of onset of disease, and otolith repositioning for 2 or more times were found to be independent risk factors for residual symptoms(P<0.05).Conclusion Age, time of onset, and two or more otolith repositionings are independent risk factors for residual symptoms, so early diagnosis of BPPV and correct repositioning are especially important for patients, especially the elderly.

参考文献/References:

[1] Kim HJ,Lee JO,Choi JY,et al.Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea[J].J Neurol,2020,267(8):2252-2259. [2] Koç A.Benign paroxysmal positional vertigo: is it really an otolith disease?[J].Journal of International Advanced Otology,2022,18(1):62-70. [3] Kim HJ,Kim JS,Choi KD,et al.Effect of self-treatment of recurrent benign paroxysmal positional vertigo: a randomized clinical trial[J].JAMA Neurol,2023,80(3):244-250. [4] Bittar RSM,Mezzalira RM,Furtado PL,et al.Benign paroxysmal positional vertigo: diagnosis and treatment[J].Int Tinnitus J,2011,16(2):135-145. [5] von Brevern M,Bertholon P,Brandt T,et al.Benign paroxysmal positional vertigo: diagnostic criteria[J].J Vestib Res,2015,25(3/4):105-117. [6] Zamergrad MV,Grachev SP,Gergova AA.Ostroe vestibuliarnoe golovokruzhenie v pozhilom vozraste: insul't ili perifericheskaia vestibulopatiia(Acute vestibular disorder in the elderly:stroke or peripheral vestibulopathy)[J].Zh Nevrol Psikhiatr Im S S Korsakova,2018,118(6Vyp2):46-49 [7] Giannini S,Signorini L,Bonanome L,et al.Benign paroxysmal positional vertigo(BPPV): it may occur after dental implantology. A mini topical review[J].Eur Rev Med Pharmacol Sci,2015,19(19):3543-3547. [8] Kansu L,Aydin E,Gulsahi K.Benign paroxysmal positional vertigo after nonotologic surgery: case series[J].J Maxillofac Oral Surg,2015,14(1):113-115. [9] Shih CP,Wang CH,Chung CH,et al.Increased risk of benign paroxysmal positional vertigo in patients with non-apnea sleep disorders: a nationwide, population-based cohort study[J].J Clin Sleep Med,2018,14(12):2021-2029. [10] Yu SD,Liu FY,Cheng ZX,et al.Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review[J].BMC Neurol,2014,14:110. [11] Chen JB,Zhang SL,Cui K,et al.Risk factors for benign paroxysmal positional vertigo recurrence: a systematic review and meta-analysis[J].J Neurol,2021,268(11):4117-4127. [12] Casani AP,Gufoni M.Recurring benign paroxysmal positional vertigo after successful canalith repositioning manoeuvers[J].Acta Otorhinolaryngol Ital,2023,43(Suppl 1):S61-S66. [13] Zuma E,Maia FC,de Fraga RB, et al.Seasonality and solar radiation variation level in benign paroxysmal positional vertigo[J].Acta Otolaryngol,2019,39(6):497-499. [14] 姜佩依,赵婷,张思然,等.神经内科门诊良性阵发性位置性眩晕发病与复发因素分析[J].中华耳科学杂志,2023,21(4):458-463. [15] Jeong SH,Kim JS,Shin JW,et al.Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo[J].J Neurol,2013,260(3):832-838. [16] Guerra J,Devesa J.Causes and treatment of idiopathic benign paroxysmal positional vertigo based on endocrinological and other metabolic factors[J].J Otol,2020,15(4):155-160. [17] Picciotti PM,Di Cesare T,Tricarico L,et al.Is drug consumption correlated with benign paroxysmal positional vertigo(BPPV)recurrence?[J].Eur Arch Otorhinolaryngol,2020,277(6):1609-1616. [18] Maslovara S,Koec A. Post-COVID-19 benign paroxysmal positional vertigo[Z], 2021: 9967555. [19] Kim JS,Zee DS.Clinical practice[J].Benign paroxysmal positional vertigo.N Engl J Med,2014,370(12):1138-1147. [20] Andrade LR,Lins U,Farina M,et al.Immunogold TEM of otoconin 90 and otolin-relevance to mineralization of otoconia,and pathogenesisof benign positional vertigo[J].Hear Res,2012,292(1/2):14-25. [21] Galluzzi F,Garavello W.Benign paroxysmal positional vertigo in children: a narrative review[J].Journal of International Advanced Otology,2022,18(2):177-182. [22] Brodsky JR,Lipson S,Wilber J,et al.Benign paroxysmal positional vertigo(BPPV)in children and adolescents: clinical features and response to therapy in 110 pediatric patients[J].Otol Neurotol,2018,39(3):344-350. [23] Jeong SH. Benign paroxysmal positional vertigo risk factors unique to perimenopausal women[Z], 2020: 589605. [24] Bazoni JA,Mendes WS,Meneses-Barriviera CL,et al.Physical activity in the prevention of benign paroxysmal positional vertigo: probable association[J].Int Arch Otorhinolaryngol,2014,18(4):387-390. [25] Anagnostou E,Kouzi I,Spengos K.Diagnosis and treatment of anterior-canal benign paroxysmal positional vertigo:a systematic review[J].J Clin Neurol,2015,11(3):262-267. [26] Si LH,Ling X,Li ZY,et al.Clinical characteristics of patients with multi-canal benign paroxysmal positional vertigo[J].Braz J Otorhinolaryngol,2022,88(1):89-100. [27] You P,Instrum R,Parnes L.Benign paroxysmal positional vertigo[J].Laryngoscope Investig Otolaryngol,2018,4(1):116-123. [28] Shim DB.Treatment of benign paroxysmal positional vertigo: an approach considering patients' convenience[J].Clin Exp Otorhinolaryngol,2020,13(4):320-321. [29] Haynes DS,Resser JR,Labadie RF,et al.Treatment of benign positional vertigo using the semont maneuver: efficacy in patients presenting without nystagmus[J].Laryngoscope,2002,112(5):796-801. [30] Kim HJ,Park JH,Kim JS.Update on benign paroxysmal positional vertigo[J].J Neurol,2021,268(5):1995-2000. [31] Pérez-Vázquez P,Franco-Gutiérrez V.Treatment of benign paroxysmal positional vertigo[J].A clinical review.J Otol,2017,12(4):165-173. [32] Song MH,Kong TH,Shim DB.Optimal reassessment time for treatment response in posterior canal benign paroxysmal positional vertigo[J].Laryngoscope,2020,130(2):496-499. [33] Choi SY,Lee MJ,Oh EH,et al. Short-Term central adaptation in benign paroxysmal positional vertigo[Z], 2020: 260. [34] Balatsouras DG,Koukoutsis G,Fassolis A,et al.Benign paroxysmal positional vertigo in the elderly: current insights[J].Clin Interv Aging,2018,13:2251-2266. [35] Chen G,Zhao X,Yu G,et al.Otolith dysfunction in recurrent benign paroxysmal positional vertigo after mild traumatic brain injury[J].Acta Otolaryngol,2019,139(1):18-21. [36] Bressi F,Vella P,Casale MNE,et al.Vestibular rehabilitation in benign paroxysmal positional vertigo:reality or fiction?[J].Int J Immunopathol Pharmacol,2017,30(2):113-122. [37] Palmeri R,Kumar A. Benign paroxysmal positional vertigo[Z], 2024: 2926198. [38] Leveque M,Labrousse M,Seidermann L,et al.Surgical therapy in intractable benign paroxysmal positional vertigo[J].Otolaryngology-Head and Neck Surgery,2007,136(5):693-698. [39] Jilla AM,Roberts RA,Johnson CE.Teaching patient-centered counseling skills for assessment, diagnosis, and management of benign paroxysmal positional vertigo[J].Semin Hear,2018,39(1):52-66.

更新日期/Last Update: 2024-10-20