良性阵发性位置性眩晕预后影响因素和残存症状的研究OA
Study on prognostic factors and residual symptoms of benign paroxysmal positional vertigo
目的 研究良性阵发性位置性眩晕(BPPV)短期预后不良的独立危险因素,探讨治疗后残存症状的情况.方法 回顾性连续纳入516 例 BPPV 患者,比较短期内(10 d)的治疗疗效,并根据眼震电图下患者有无眼震和有无眩晕分为预后良好组和预后不良组,对比两组患者治疗前后的临床数据.采用多因素Logistic 回归分析探讨短期预后不良的独立危险因素.并分析中期(90 d)的预后情况,探讨残存症状与心理因素相关性.并采用眩晕障碍量表(DHI)评估前庭功能的康复进展.结果 本研究中,预后良好组 471 例,预后不良组45 例.单因素分析发现,预后良好组与预后不良组在焦虑、抑郁、年龄≥65 岁、是否住院、25-羟基维生素 D 含量、颈椎病、复位次数<3 次、眼震持续时间等方面的比较差异具有统计学意义(均 P<0.05).多因素 Logistic 回归分析显示,颈椎病(OR=6.498,95%CI:1.755～24.063,P=0.005)、门诊治疗(OR=1.397,95%CI:1.075～1.816,P=0.012)、眼震持续时间>60 s(OR=2.625,95%CI:1.848～3.730,P<0.001)和复位次数(OR=1.216,95%CI:1.081～1.367,P=0.001)是影响 BPPV 短期内恢复的独立危险因素.治疗 90 d后两组患者在 DHI 评分的差异具有统计学意义(P<0.05),而在躯体性指数、功能性指数评分的差异均无统计学意义.结论 BPPV 总体预后良好,颈椎病、门诊治疗、眼震持续时间、复位次数是影响 BPPV 短期内恢复的独立危险因素.残存症状与焦虑抑郁评分成正比,可能受到心理因素影响较大,制定个体化的治疗方案,尤其是心理干预应对焦虑抑郁可能更加有益于 BPPV 患者残余症状的恢复.
Objective To study the independent risk factors of unfavourable prognosis in the short-term of benign paroxysmal positional vertigo(BPPV),and to explore the relationship between residual symptoms and psychological factors during treatment.Methods A total of 516 consecutive patients with BPPV were retrospectively enrolled.To compare effect of short-term treatment(10 d),the patients without nystagmus and vertigo under electronystagmography were defined as the favourable-prognosis-group,other patents were enrolled in bad-prognosis-group.The clinical data were collected and compared between the two groups.Multivariate Logistic regression was used to analyze the independent risk factors of unfavourable prognosis in the short-term.To observe the medium-term(90 d)prognosis,analyze the correlation between residual symptoms and psychological factors,and the rehabilitation progress of vestibular function was evaluated by Dizziness Handicap Inventory Scale(DHI).Results There were 471 cases in the good prognosis group and 45 cases in the poor prognosis group.Univariate analysis revealed that there were statistically significant differences between the good prognosis group and the poor prognosis group in terms of anxiety,depression,age≥65 years,hospitalization status,25-hydroxyvitamin D level,cervical spondylosis,number of repositioning maneuvers<3,and duration of nystagmus(all P<0.05).Multivariate Logistic regression analysis showed that cervical spondylosis(OR=6.498,95%CI:1.755-24.063,P=0.005),outpatient(OR=1.397,95%CI:1.075-1.816,P=0.012),nystagmus lasts more than 60 s each time(OR=2.625,95%CI:1.848-3.730,P<0.01),and number of manual reduction(OR=1.216,95%CI:1.081-1.367,P=0.001)were independent risk factors affecting the short-term recovery of BPPV.After 90 d of treatment,there was a significant difference in the scores of emotional index in DHI between the two groups(P<0.05),but there was no significant difference in the scores of somatic index and functional index.Conclusions The prognosis of BPPV is good.Cervical spondylosis,outpatient treatment,duration of nystagmus and times of reduction are independent risk factors affecting the short-term recovery of BPPV.Residual symptoms was positively correlated with anxiety and depression scores.
田鸿福;王宇;顾嘉晨;艾志兵;邱峰
201700 上海,复旦大学附属中山医院青浦分院神经内科南京医科大学第四附属医院神经内科201700 上海,复旦大学附属中山医院青浦分院神经内科201700 上海,复旦大学附属中山医院青浦分院神经内科南京医科大学附属脑科医院脑血管病救治中心
医药卫生
良性阵发性位置性眩晕短期预后中期预后手法复位半规管
benign paroxysmal positional vertigoshort-term prognosismedium-term prognosismanual reductionsemicircular canal
《临床神经病学杂志》 2026 (3)
210-214,5
南京市卫生科技发展专项资金项目计划(ZKX23039)
评论