Sheikhzadeh Mahboobeh, Lotfi Yones, Mousavi Abdollah, Heidari Behzad, Bakhshi Enyatollah
1.Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2.Iran University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2016 Summer;7(3):173-177.
Benign paroxysmal positional vertigo (BPPV) is a condition with recurrent attacks in a significant proportion of patients. The present case- control study was conducted to assess the influence of serum vitamin D normalization on recurrent attacks of vitamin D deficient patients.
Diagnosis of BPPV was made based on history and clinical examination and exclusion of other conditions. Serum 25-hydroxy vitamin D (25-OHD) was measured using ELISA method and a levels of < 20 ng/ml was considered a deficiency of vitamin D. Inclusion criteria were as follows: history of recurrent attacks and serum 25-OHD<20.ng/ml. While the patients with history of trauma, surgery and chronic systemic diseases were excluded. The patients were classified into two groups: treatment and control, intermittently. Both groups received Epley rehabilitation therapy one session per week for 4 weeks but the treatment group received an additional supplement of 50.000 IU of vitamin D (cholecalciferol) weekly for two months to achieve serum 25-OHD ≥ 30 ng/ml and the study patients were followed-up for 6 months.
Twenty-seven patients were allocated to each group. At baseline, serum 25-OHD was similar (10.7±2.3 vs 11.41±1.9, P=0.23). At month 2, serum 25-OHD in the treatment group increased significantly to ≥ 30 ng/ ml, whereas serum 25-OHD in the control group remained unchanged (34.2±3.3 vs 10.6 10.6±2.2 ng/ml, P=0.001). During the follow-up period, attacks of BPPV in the treatment group decreased significantly compared with the control group (14.8% vs 96.3% OR= 0.18, P=0.001).
The findings of this study indicate that the normalization of serum vitamin D significantly reduces BPPV recurrences.
良性阵发性位置性眩晕(BPPV)在相当一部分患者中会反复发作。本病例对照研究旨在评估血清维生素D水平正常化对维生素D缺乏患者复发的影响。
BPPV的诊断基于病史、临床检查以及排除其他疾病。采用酶联免疫吸附测定(ELISA)法测定血清25-羟维生素D(25-OHD),25-OHD水平<20 ng/ml被认为维生素D缺乏。纳入标准如下:有复发史且血清25-OHD<20 ng/ml。排除有创伤、手术和慢性全身性疾病史的患者。患者被间歇性分为两组:治疗组和对照组。两组均每周接受1次Epley康复治疗,共4周,但治疗组每周额外补充50000 IU维生素D(胆钙化醇),持续2个月,以使血清25-OHD≥30 ng/ml,并对研究患者进行6个月的随访。
每组分配27例患者。基线时,血清25-OHD相似(10.7±2.3 vs 11.41±1.9,P = 0.23)。在第2个月时,治疗组血清25-OHD显著升高至≥30 ng/ml,而对照组血清25-OHD保持不变(34.2±3.3 vs 10.6±2.2 ng/ml,P = 0.001)。在随访期间,治疗组BPPV发作较对照组显著减少(14.8% vs 96.3%,OR = 0.18,P = 0.001)。
本研究结果表明,血清维生素D水平正常化可显著降低BPPV的复发率。