后半规管良性阵发性位置性眩晕发作与头部睡眠姿势相关性分析

目的　研究睡眠姿势与后半规管良性阵发性位置性眩晕（posterior semicircular canal benign paroxysmal positional vertigo，PSC-BPPV）发病的关系，为临床BPPV的预防和治疗提供指导。方法　采用Dix-Hallpike试验，对208例确诊为PSC-BPPV患者进行问卷调查，内容包括眩晕的诱发体位、伴随症状、与睡眠姿势的关系及眩晕持续时间等。重点对PSC-BPPV病变耳和睡眠时头部姿势进行调查，分析两者相关性。结果　PSC-BPPV诱发体位主要是卧位坐起和躺下，伴随症状主要为恶心、呕吐，耳鸣很少，无听力下降，眩晕持续时间很少超过60 s。208例PSC-BPPV患者中125例睡眠时总采取同一姿势（右侧卧85例，左侧卧40例），83例患者睡眠姿势不定。PSC-BPPV病变耳与患者头部睡眠姿势侧别具有较好一致性（Kappa系数=0.401＞0）。Spearman相关性分析发现PSC-BPPV病变耳与头部睡眠姿势侧别比较（r =0.203，P＜0.05），与年龄比较（r =-0.179，P＜0.05），差异具有统计学意义，与性别比较差异无统计学意义。结论　习惯性头部睡眠姿势促使耳石沉积在低位耳的后半规管，是导致同侧PSC-BPPV的主要因素之一。

Correlation analysis of the incidence and head position in posterior semicircular canal benign paroxysmal positional vertigo

OBJECTIVE To verify the relationship between the incidence and habitual head position in bed in posterior semicircular canal benign paroxysmal positional vertigo(PSC-BPPV), and to provide practical information for the prevention and treatment of BPPV.METHODS There were 208 patients with PSC-BPPV were included in this study. The relationship of affected semicircular canals in PSC-BPPV patients and the habitual head positions in bed were analyzed.RESULTS There were 125 patients who had always taken the same position (right side lying in 85 cases, left side lying in 40 cases), and 83 cases in different positions. The affected PSC-BPPV were consonant with the head positions (Kappa=0.401). With Spearman correlation analysis, we can find that there was correlation between the affected PSC-BPPV and the head position(r=0.203) and age(r=-0.179,P<0.05), but there were no significant correlation with gender.CONCLUSION Habitual head position causes otoliths deposit in PSC at the lowest level during bedrest, and was one of the main factors leading to the ipsilateral PSC-BPPV.