老年良性阵发性位置性眩晕：单中心研究。
Geriatric benign paroxysmal positional vertigo: a single-center study.
机构信息
Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Department of Neurology, Peking, China.
Peking University Aerospace School of Clinical Medicine, Aerospace Center Hospital, Department of Neurology, Peking, China.
出版信息
Braz J Otorhinolaryngol. 2023 Jul-Aug;89(4):101277. doi: 10.1016/j.bjorl.2023.101277. Epub 2023 Jun 3.
OBJECTIVE
To compare the clinical features, risk factors, distribution of Benign Paroxysmal Positional Vertigo (BPPV) subtypes, and effectiveness of canalith repositioning between geriatric and non-geriatric patients with BPPV.
METHODS
A total of 400 patients with BPPV were enrolled. Canalith repositioning was performed according to the semicircular canals involved. Patients were divided by age into a geriatric group (≥60 years) and a non-geriatric group (20-59 years). Clinical characteristics, potential age-related risk factors, distribution of subtypes, and effectiveness of canalith repositioning were compared between the groups.
RESULTS
Female sex was significantly more common in all age groups, with a peak female-to-male ratio of 5.1:1 in the group aged 50-59 years. There was a higher proportion of men in the geriatric group. A history of disease associated with atherosclerosis was significantly more common in the geriatric group (p < 0.05). Migraine was significantly more common in the non-geriatric group (p = 0.018), as was posterior canal BPPV. The horizontal canal BPPV (especially horizontal canal BPPV-cupulolithiasis), and multicanal BPPV subtypes were more common in the geriatric group, whereas anterior canal BPPV was more common in the non-geriatric group. Two canalith repositioning sessions were effective in 58.0% of the geriatric cases and in 72.6% of the non-geriatric cases (p = 0.002). There was a tendency for the effectiveness of canalith repositioning to decrease with increasing age.
CONCLUSION
BPPV was more common in women. However, the proportion of men with BPPV increased with age. Elderly patients often had a history of diseases associated with atherosclerosis (i.e., hypertension, diabetes, and hyperlipidemia). The horizontal canal BPPV (particularly horizontal canal BPPV-cupulolithiasis) and multicanal BPPV subtypes were more common and the anterior canal BPPV subtype was less common in elderly patients. The effectiveness of canalith repositioning may decrease with age. Therefore, older patients should receive more comprehensive medical treatment.
目的
比较老年和非老年良性阵发性位置性眩晕（BPPV）患者的临床特征、危险因素、BPPV 亚型分布和耳石复位治疗效果。
方法
共纳入 400 例 BPPV 患者。根据受累半规管进行耳石复位治疗。根据年龄将患者分为老年组（≥60 岁）和非老年组（20-59 岁）。比较两组患者的临床特征、潜在年龄相关危险因素、亚型分布和耳石复位治疗效果。
结果
各年龄段女性患者均明显多于男性，50-59 岁年龄组女性与男性的比例峰值为 5.1:1。老年组男性比例较高。老年组患者动脉粥样硬化相关疾病史的比例明显较高（p<0.05）。非老年组偏头痛的比例明显较高（p=0.018），而后半规管 BPPV 也更为常见。后半规管 BPPV（尤其是后半规管 BPPV-嵴帽结石症）和多管 BPPV 亚型在老年组更为常见，而前半规管 BPPV 在非老年组更为常见。耳石复位治疗 2 个疗程后，老年组有效率为 58.0%，非老年组为 72.6%（p=0.002）。耳石复位治疗效果有随年龄增长而降低的趋势。
结论
BPPV 更常见于女性。然而，BPPV 男性患者的比例随年龄增长而增加。老年患者常有动脉粥样硬化相关疾病史（即高血压、糖尿病和高脂血症）。老年患者水平半规管 BPPV（特别是水平半规管 BPPV-嵴帽结石症）和多管 BPPV 亚型更为常见，前半规管 BPPV 亚型更为少见。耳石复位治疗效果可能随年龄增长而降低。因此，老年患者应接受更全面的治疗。
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