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血管炎对良性阵发性位置性眩晕(BPPV)发病的可能作用。

The possible contribution of angiitis to the onset of benign paroxysmal positional vertigo (BPPV).

作者信息

Goto Fumiyuki, Hayashi Ken, Kunihiro Takanobu, Ogawa Kaoru

机构信息

Department of Otorhinolaryngology, Hino Municipal Hospital, Tokyo, Japan.

出版信息

Int Tinnitus J. 2010;16(1):25-8.

Abstract

OBJECTIVE

The aim was to evaluate the oxidative stress and the angiitis in patients with BPPV.

METHOD

Patients with benign paroxysmal positional vertigo (BPPV) within 14 days of onset were analyzed. The level of diacron reactive oxygen metabolites (d-ROM) and circulating soluble vascular cell adhesion molecule 1 (VCAM-1), were evaluated. As a treatment the patients were taught to perform the Brandt-Daroff exercise at home by themselves. The prognosis of BPPV, which is measured as the time until the disappearance of positional nystagmus by a physician during the outpatient visit each week, the relation among the level of oxygen metabolites, vascular molecule and the duration until remission were analyzed.

RESULTS

The patients who required longer time for the disappearance of positional nystagmus showed high d-ROM and VCAM levels, whereas those who required shorter time for remission showed lower d-ROM and VCAM levels.

CONCLUSION

There is an increased expression of VCAM-1 and d-ROM confirming the existence of an angiitis and supporting the vascular involvement in BPPV. The identification of the high levels of d-ROM and VCAM-1 can open the way to selective pharmacological treatments able to correct the oxidative stress and activation of endothelial cells.

摘要

目的

旨在评估良性阵发性位置性眩晕(BPPV)患者的氧化应激和血管炎情况。

方法

对发病14天内的良性阵发性位置性眩晕(BPPV)患者进行分析。评估了二乙酰反应性氧代谢产物(d-ROM)水平和循环可溶性血管细胞黏附分子1(VCAM-1)水平。作为治疗手段,教导患者在家自行进行Brandt-Daroff训练。以每周门诊时医生测量的位置性眼球震颤消失所需时间来衡量BPPV的预后,分析了氧代谢产物水平、血管分子与缓解所需时间之间的关系。

结果

位置性眼球震颤消失所需时间较长的患者d-ROM和VCAM水平较高,而缓解所需时间较短的患者d-ROM和VCAM水平较低。

结论

VCAM-1和d-ROM表达增加,证实了血管炎的存在,并支持血管参与BPPV的发病过程。d-ROM和VCAM-1高水平的鉴定可为能够纠正氧化应激和内皮细胞激活的选择性药物治疗开辟道路。

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