特发性良性阵发性位置性眩晕复位后残余头晕与脑血管反应性的关系

目的 探讨特发性良性阵发性位置性眩晕（BPPV）患者在复位成功后残余头晕（RD）的发生与脑血管反应性（CVR）的关系。方法 记录117例特发性BPPV患者的眩晕残障评定量表（DHI）评分,复位成功后应用经颅多普勒血流分析仪通过屏气试验（BHI）测定CVR,观察1周内患者RD的发生情况,根据是否存在RD将117例患者分为RD组（46例）及非RD组（71例）,分析BPPV复位成功后RD与CVR的关系。结果 RD组患者的DHI总分高于非RD组,且DHI子项目情绪和功能的评分也高于非RD组（P均< 0.05）。 非RD组BHI高于RD组（P < 0.05）。非RD组发作时头晕症状的轻重与BHI无关（P > 0.05）,RD组发作时头晕症状与BHI相关（P < 0.05）。结论 BPPV患者发作时情绪和功能方面的异常或会增加复位成功后RD的发生率,良好的CVR或可降低RD的发生率。

Relationship between residual dizziness and cerebrovascular reactivity after reduction of idiopathic benign paroxysmal positional vertigo

Objective To investigate the relationship between residual dizziness （RD） and cerebrovascular reactivity （CVR） in patients with idiopathic benign paroxysmal positional vertigo （BPPV） after successful manipulative reduction. Methods Dizziness Handicap Inventory （DHI） scores of 117 patients with idiopathic BPPV were recorded. After successful manipulative reduction, CVR was measured by breath-hold-at-inhalation （BHI） with transcranial doppler （TCD） ultrasound, and the incidence of RD within one week was observed. All patients were divided into the RD group （n = 46） and non-RD group （n = 71） according to the presence of RD. the relationship between RD and CVR after reduction was analyzed. Results The total score of DHI in patients with RD after reduction was significantly higher than that in those without RD, especially the DHI-E and DHI-F scores （all P < 0.05）. BHI in patients without RD was significantly higher than that in patients with RD （P < 0.05）. In the non-RD group, the severity of vertigo was not associated with BHI （P > 0.05）, whereas there was a correlation between vertigo and BHI in the RD group （P < 0.05）. Conclusion The abnormal emotion and physical function of BPPV patients may increase the risk of RD after reduction. Good CVR might reduce the occurrence of RD.