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良性阵发性位置性眩晕复发的临床特征及危险因素

Clinical Characteristics and Risk Factors for the Recurrence of Benign Paroxysmal Positional Vertigo.

作者信息

Zhu Cui Ting, Zhao Xing Qquan, Ju Yi, Wang Yan, Chen Mei Mei, Cui Yu

机构信息

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

China National Clinical Research Center for Neurological Diseases, Beijing, China.

出版信息

Front Neurol. 2019 Nov 13;10:1190. doi: 10.3389/fneur.2019.01190. eCollection 2019.

Abstract

Benign paroxysmal positional vertigo (BPPV) manifests itself as a paroxysm of vertigo and nystagmus lasting several seconds, which is self-limiting. The clinical characteristics and risk factors for the recurrence of BPPV in different ages have not yet been investigated. A retrospective observational study was conducted in the Department of Neurology in Beijing Tiantan Hospital from July 2009 to June 2015. The study included 1,012 patients aged 18-93 years. All patients received the definitive diagnosis and canalith repositioning maneuvers treatment and finally accomplished follow-up. Demographic variables, potential recurrence risk factors, neurological examination, and laboratory indexes were assessed. The -test or chi-squared test was first performed for group comparison, then logistic regression analysis was used to investigate the risk factors of BPPV recurrence. The 1-year recurrence rates of BPPV patients after reposition maneuvers were, respectively, 22.79% (aged 18-45 years), 23.92% (aged 45-60 years), 28.89% (over 60 years). The recurrence rates among the three groups have no statistically significant difference. Logistic regression analysis shows that women BPPV patients have more recurrence risks than do men. Ménière's disease (odds ratio = 6.009, 95% confidence interval: 2.489-14.507, < 0.001), hypertension (odds ratio = 1.510, 95% confidence interval: 1.095-2.084, = 0.012), migraine (odds ratio = 2.534, 95% confidence interval: 1.164-5.516, = 0.019), and hyperlipemia (odds ratio = 1.419, 95% confidence interval: 1.024-1.968, = 0.036) were risk factors for the recurrence of BPPV in patients. We conclude that Ménière's disease, hypertension, migraine, and hyperlipemia may be independent risk factors for the recurrence of BPPV in patients, but aging does not increase the recurrence risk.

摘要

良性阵发性位置性眩晕(BPPV)表现为持续数秒的眩晕和眼球震颤发作,具有自限性。不同年龄段BPPV复发的临床特征和危险因素尚未得到研究。2009年7月至2015年6月在北京天坛医院神经内科进行了一项回顾性观察研究。该研究纳入了1012例年龄在18 - 93岁的患者。所有患者均接受了明确诊断和半规管结石复位手法治疗并最终完成随访。评估了人口统计学变量、潜在复发风险因素、神经学检查和实验室指标。首先进行t检验或卡方检验用于组间比较,然后采用逻辑回归分析来研究BPPV复发的危险因素。复位手法后BPPV患者的1年复发率分别为22.79%(18 - 45岁)、23.92%(45 - 60岁)、28.89%(60岁以上)。三组之间的复发率无统计学显著差异。逻辑回归分析表明,女性BPPV患者比男性有更多的复发风险。梅尼埃病(比值比 = 6.009,95%置信区间:2.489 - 14.507,P < 0.001)、高血压(比值比 = 1.510,95%置信区间:1.095 - 2.084,P = 0.012)、偏头痛(比值比 = 2.534,95%置信区间:1.164 - 5.516,P = 0.019)和高脂血症(比值比 = 1.419,95%置信区间:1.024 - 1.968,P = 0.036)是患者BPPV复发的危险因素。我们得出结论,梅尼埃病、高血压、偏头痛和高脂血症可能是患者BPPV复发的独立危险因素,但年龄增长并不会增加复发风险。

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