梅尼埃病畏光畏声症状的临床分析

摘要

Objective To report photophobia and phonophobia in patients with Meniere's disease and discuss their mechanisms of pathogenesis and significance in diagnosis and treatment.Methods This retrospective study includ-ed 105 cases of Meniere's disease with reliable description of symptoms.Patient gender,age,hearing loss and migraine symptoms in relation with photophobia and phonophobia were analyzed.Results Sixty three of the 105 cases (60%) presented with photophobia and/or phonophobia.Of the 44 male cases,21(47.7%)complained of photophobia and/or phonophobia,while photophobia and/or phonophobia were reported in 42 of the female 61 cases(68.9%).The differ-ence was statistically significant(P0.05).The occurrence rate of photophobia and/or phonophobia was 100%(2/2)in patients who were 20 years old or younger,54.5%(12/22)in those who were 20-40 years old,63.0%(34/54)in those 41-60 years old and 55.6%(15/27)in patients older than 61 years(P0.05).The occurrence rate of photophobia and/or phonophobia was 62.5%(5/8)for average hearing threshold of 25 dB HL or better,46.7%(14/30)when the threshold was 26-40 dB HL,68.0%(34/50)when 41-70 dB HL and 58.8%(10/17)when it was higher than 70 dB HL(P0.05).In cases with migraine symptoms,the occurrence rate of photophobia and/or phonophobia was 68.8%(22/32),similar to those without migraine symptoms(56.2%,41/73),showing no correlation among these symptoms.Conclusion Report of photophobia and phonophobia in Meniere's disease is more common in women with than in men,with no significant correlation with age,hearing loss or migraine symptoms.It may be related to the pathologic mechanisms of Meniere' disease,central regulation and concurrent central dysfunctions.%目的 通过对梅尼埃病患者畏光畏声伴随症状的临床分析,探讨其产生机制以及对于梅尼埃病诊治的临床意义.方法 回顾分析能准确提供主诉症状的105例梅尼埃病确诊病例,根据性别、年龄、听力分期、头痛情况进行分组,了解其与畏光畏声症状之间的关系.结果 ①所有梅尼埃确诊病例105例,畏光或(和)畏声出现率60%(63/105).②男性44例,畏光或(和)畏声出现率47.7%(21/44);女性61例,畏光或(和)畏声出现率68.9%(42/61);性别差异有统计学意义(P0.05).③20岁2例,畏光或(和)畏声出现率100%(2/2);20~40岁22例,畏光或(和)畏声出现率54.5%(12/22);41~60岁54例,畏光或(和)畏声出现率63.0%(34/54);60岁27例,畏光或(和)畏声出现率55.6%(15/27);年龄差异无统计学意义(P0.05).④25dBHL 8例,畏光或(和)畏声出现率62.5%(5/8);26~40dBHL 30例,畏光或(和)畏声出现率46.7%(14/30);41~70dBHL 50例,畏光或(和)畏声出现率68.0%(34/50);70dBHL 17例,畏光或(和)畏声出现率68.0%(34/50);听力差异无统计学意义(P0.05).⑤头痛32例,畏光或(和)畏声出现率68.8%(22/32);未曾出现头痛73例,畏光或(和)畏声出现率56.2%(41/73);出现畏光或(和)畏声与头痛之间无关联性(P0.05).结论 梅尼埃病出现畏光畏声伴随症状,女性患者较男性多见,与年龄、听力损失程度、头痛无明显相关性,从而推断其产生原因与梅尼埃病理机制以及中枢调节、中枢功能紊乱的共患疾病等多因素相关.