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不同年龄组前庭神经炎患者的临床特征和结局。

Vestibular Neuritis in Patients Among Different Age Groups: Clinical Features and Outcomes.

机构信息

Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan, People's Republic of China.

NHC Key Laboratory of Otorhinolaryngology, Shandong University, Jinan, People's Republic of China.

出版信息

J Am Acad Audiol. 2020 Oct;31(9):629-635. doi: 10.1055/s-0040-1717067. Epub 2020 Oct 9.

Abstract

BACKGROUND

Patients with vestibular neuritis (VN) displayed differential prognosis despite of the same treatment. Thus, identifying unique characteristics in different populations and creating individually customized treatments are necessary. However, studies about the clinical features according to different ages are scarce.

PURPOSE

This article compares the differences in VN patients among different age groups.

RESEARCH DESIGN

A prospective study.

STUDY SAMPLE

A total of 70 VN patients were enrolled in the present study.

INTERVENTION

All the patients started vestibular rehabilitation at the time of initial presentation to our clinic. They were followed up at 1-month intervals using the questionnaire until 4 months.

DATA COLLECTION AND ANALYSIS

Patients' clinical data including clinical presentation, vestibular testing results, treatment, and recovery was collected and analyzed with Duncan's multiple range test, the sign test, and the Kruskal-Wallis test using SPSS18.0.

RESULTS

The mean age of the 70 patients was 47.2 ± 17.1, ranging from 10 to 76 years old. The sex ratios (male:female) were 3.5 in the adolescent group, 0.643 in the young adult group, 1.375 in the middle-aged group, and 0.583 in the senior group. The prevalence of hypertension and diabetes mellitus showed a significantly increasing trend from young adults to the seniors ( < 0.05). The caloric response was statistically worse in the senior group than the other groups ( < 0.05). The abnormal rates for video head impulse test, vestibular-evoked myogenic potential, and vestibular autorotation test did not differ significantly in different age groups. A significant difference between prerehabilitation and postrehabilitation total Dizziness Handicap Inventory (DHI) scores was identified in all the groups ( < 0.05). The younger patients demonstrated a greater improvement than patients in the senior group, meanwhile adolescents improved the most ( < 0.05). Hospital Anxiety and Depression Scale (HADS) was the lowest in the adolescent group ( < 0.05). DHI score at acute stage was significantly correlated with HADS ( = 0.597,  < 0.05).

CONCLUSION

The canal response was statistically better for younger patients compared with the elderly. The younger patients demonstrated a greater improvement than patients in the senior group, among whom adolescents improved the most, meanwhile psychological factors played a minor role in adolescents. Self-perceived disability-handicap positively correlated with anxiety and depression in all patients.

摘要

背景

尽管接受了相同的治疗,前庭神经炎(VN)患者的预后仍存在差异。因此,有必要在不同人群中识别出独特的特征,并制定个体化的治疗方案。然而,关于不同年龄组患者的临床特征的研究很少。

目的

本文比较了不同年龄组 VN 患者之间的差异。

研究设计

前瞻性研究。

研究样本

本研究共纳入 70 例 VN 患者。

干预措施

所有患者在首次就诊时即开始进行前庭康复治疗。他们在 4 个月内每隔 1 个月通过问卷调查进行随访。

数据收集和分析

采用 Duncan 多重范围检验、符号检验和 Kruskal-Wallis 检验,使用 SPSS18.0 对患者的临床资料(临床表现、前庭测试结果、治疗和恢复情况)进行收集和分析。

结果

70 例患者的平均年龄为 47.2±17.1 岁,年龄范围为 10 至 76 岁。青少年组的男女比例(男:女)为 3.5,青年组为 0.643,中年组为 1.375,老年组为 0.583。高血压和糖尿病的患病率从青年组到老年组呈明显上升趋势(<0.05)。与其他组相比,老年组的冷热刺激试验反应明显较差(<0.05)。各组视频头脉冲试验、前庭诱发肌源性电位和前庭自主旋转试验的异常率无显著差异。所有组患者在康复前和康复后的总体眩晕残障程度量表(DHI)评分之间均存在显著差异(<0.05)。与老年组相比,年轻患者的改善更为显著,而青少年的改善最为显著(<0.05)。青少年组的医院焦虑和抑郁量表(HADS)评分最低(<0.05)。急性期 DHI 评分与 HADS 评分显著相关(=0.597,<0.05)。

结论

与老年人相比,年轻患者的管反应更好。与老年组相比,年轻患者的改善更为显著,其中青少年的改善最为显著,而心理因素在青少年中作用较小。所有患者的自我感知残疾障碍与焦虑和抑郁呈正相关。

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