突发性耳聋继发良性阵发性位置性眩晕的相关发病因素分析

摘要

目的:回顾性分析继发于突发性耳聋的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的临床资料,并探讨其可能的发病因素.方法:观察2012年12月至2016年12月于我院耳鼻咽喉科门诊及病房就诊的240例突发性耳聋患者继发BPPV的发病情况,进行相关发病因素的调查.结果:本组突发性耳聋继发BPPV者,男女性别之间差异显著(x2=9.898,P =0.002).不同年龄分组中3组组间差异显著(X2=13.145,P=0.001).240例突发性耳聋患者具有高血压、糖尿病两者中至少1种疾病者45例,据合并或不合并高血压或糖尿病,将突发性耳聋继发BPPV者分为两组,两组间有差异显著(x2=15.168,P=0.001).按听力损失程度分组,39例继发BPPV者患者听力损失均为中重度和重度耳聋,其中中重度突聋患者继发BPPV者25例,重度突聋患者继发BPPV者14例,两组之间无显著性差异(X2=1.533,P=0.216).39例继发于突发性耳聋的BPPV,出现时间均在突发性耳聋发病后10 d内.继发于突发性耳聋的BPPV的手法复位效果与原发性BPPV相似,大多数都于1～2次就诊后治愈.结论:对于继发于突发性耳聋的良性阵发性位置性眩晕,女性较男性发病高,中年人,听力损失程度重者,合并高血压、糖尿病等全身性疾病患者发病高.故推测女性,中年,听力损失程度重,合并高血压、糖尿病等全身性疾病可能是突发性耳聋继发BPPV的相关发病因素.继发于突发性耳聋的BPPV手法复位效果良好,故对于突发性耳聋继发眩晕者,应尽早施行.%Objective:To explore the possible pathogenic factors of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) by retrospectively analyzing the clinical characteristics of patients.Methods:240 inpatients and outpatients of BPPV secondary to SD from December 2012 to December 2016 were observed and pathogenic related factors were investigated.Results:Among patients with BPPV secondary to SD,significant differences on the incidence were observed between different genders (x2 =9.898,P =0.002) and age groups (X2 =13.145,P =0.001).45 cases had at least one disease,hypertension or diabetes.There was significant difference (X2 =15.168,P =0.001) on the incidence between patients with or without comorbidities.According to the degree of hearing loss,patients were divided into 3 groups,including 25 cases of moderate-severe deafness and 14 cases severe,and no significant difference was observed between these two groups (x2 =1.533,P =0.216).All 39 cases of BPPV secondary to SD occurred within 10d after the onset of SD.The effect of manual reduction on BPPV secondary to SD was similar to that of primary BPPV,and the majority of them were cured after 1 ～ 2 visits.Conclusion:For patients having BPPV secondary to SD,the incidence is higher among women,and patients who are middle-aged,severe deafness with systemic disease like hypertension or diabetes have a higher incidence.It is speculated that female,middle-age,severe hearing loss and systemic diseases may be associated pathogenic factors of secondary BPPV.Manipulative reduction is an effective treatment,so it should be implemented as soon as possible for the patients with BPPV secondary to SD.