Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Internal Medicine, Shanghai Yangsi Hospital, Shanghai, China.
Brain Behav. 2018 Sep;8(9):e01092. doi: 10.1002/brb3.1092. Epub 2018 Aug 11.
To clarify the relationship of clinical factors with isolated vertigo or dizziness of cerebrovascular origin.
Clinical data of patients admitted in East Hospital from Jan. 2015 to Apr. 2016, whose complaint were acute vertigo or dizziness were retrospectively collected. All patients arrived at the emergency department within 24 hr of symptom onset, had no acute ischemic lesion first CT and NIHSS score of 0. Patients were divided into cerebral infarction group and noncerebral infarction group according to subsequent cerebral imaging results and clinical and laboratory factors related to cerebral infarction were analyzed.
51.6% of patients were female (n = 141). 46 patients (16.8%) were diagnosed with acute cerebral infarction. Baseline demographic data of the two groups was not significantly different. Univariate analysis found that history of smoking (p = 0.009), headache (p = 0.028), unsteadiness (p = 0.009), neuron specific enolase (p = 0.001), and vertebral artery abnormalities found on imaging (p = 0.009) were the significant difference between two groups. Increased neuron specific enolase (p = 0.005) and an abnormal vertebral artery (p = 0.044) were significant on multivariate analysis.
16.8% of acute isolated vertigo or dizziness presentations were diagnosed with acute cerebral infarction. Increased serum neuron specific enolase and vertebral artery abnormalities were the strongest indicators of acute cerebral infarction.
阐明临床因素与血管源性孤立性眩晕或头晕的关系。
回顾性收集 2015 年 1 月至 2016 年 4 月期间因急性眩晕或头晕入住我院东院的患者的临床资料。所有患者均在症状发作后 24 小时内到达急诊科,初诊 CT 未见急性缺血性病灶,NIHSS 评分为 0 分。根据后续脑影像学结果和与脑梗死相关的临床和实验室因素,将患者分为脑梗死组和非脑梗死组。
女性患者占 51.6%(n=141)。46 例(16.8%)患者被诊断为急性脑梗死。两组患者的基线人口统计学数据无显著差异。单因素分析发现,吸烟史(p=0.009)、头痛(p=0.028)、站立不稳(p=0.009)、神经元特异性烯醇化酶(p=0.001)和影像学发现椎动脉异常(p=0.009)在两组间有显著差异。多因素分析发现神经元特异性烯醇化酶升高(p=0.005)和椎动脉异常(p=0.044)具有显著意义。
16.8%的急性孤立性眩晕或头晕表现被诊断为急性脑梗死。血清神经元特异性烯醇化酶升高和椎动脉异常是急性脑梗死的最强指标。