良性阵发性位置性眩晕复发的影响因素分析

摘要

Objective To analyze the influencing factors of recurrence of benign paroxysmal positional vertigo (BPPV). Methods A total of 99 patients with BPPV were selected in Suzhou Municipal Hospital from 2010 to 2014,and they were divided into A group(with recurrence of BPPV,n = 21)and B group(without recurrence of BPPV,n = 78)according to the fellow - up outcome. Gender,age( below or equal 45 years old and over 45 years old),incidence of complications (including hypertension,diabetes,hyperlipidaemia and cervical spondylosis),vertigo types〔 simple type( with only one semicircular canal involved)and complex type(with two or more semicircular canal involved)〕,therapeutic methods(absolute medicine therapy and medicine therapy combined with manual reduction) were retrospectively collected,and the influencing factors of recurrence of BPPV were analyzed. Results No statistically significant differences of gender, incidence of hyperlipidaemia or cervical spondylosis was found between the two groups(P > 0. 05);while there were statistically significant differences of age,incidence of hypertension and diabetes,vertigo types and therapeutic methods between the two groups(P <0. 05). Multivariate Logistic regression analysis showed that,complicated with diabetes〔 OR = 6. 021,95% CI( 1. 817, 19. 953)〕and absolute medicine therapy〔 OR = 6. 295,95% CI( 1. 904,20. 807 )〕 were independent risk factors of recurrence of BPPV(P < 0. 05). Conclusion Complicated with diabetes and absolute medicine therapy are independent risk factors of recurrence of BPPV,clinical staffs should pay more attentions to control the blood glucose of patients with BPPV,and those patients without contraindications should receive manual reduction to reduce the recurrence of BPPV.%目的：分析良性阵发性位置性眩晕（ BPPV）复发的影响因素。方法选取苏州市市立医院2010—2014年收治的住院 BPPV 患者99例，按照随访结果分为复发组21例和非复发组78例。回顾性分析两组患者的性别、年龄（≤45岁或>45岁）、并发症（高血压、糖尿病、高脂血症、颈椎病）、发作类型（单纯型：累及1个半规管，复杂型：累及2个及以上半规管）、治疗方法（单纯药物治疗，药物治疗＋手法复位），分析 BPPV 复发的影响因素。结果两组患者性别、高脂血症发生率、颈椎病发生率比较，差异无统计学意义（P >0.05）；两组患者年龄、高血压发生率、糖尿病发生率、发作类型及治疗方法比较，差异有统计学意义（ P <0.05）。多因素 Logistic 回归分析结果显示，并发糖尿病〔OR =6.021，95% CI（1.817，19.953）〕、单纯药物治疗〔OR =6.295，95% CI（1.904，20.807）〕是 BPPV 复发的独立危险因素（P <0.05）。结论并发糖尿病、单纯药物治疗是 BPPV 复发的独立危险因素，临床工作人员应注意控制 BPPV 患者的血糖，无禁忌证者尽量联合手法复位，以减少 BPPV 的复发。