病史两问法在良性阵发性位置性眩晕诊断中的意义

目的探讨病史两问法（床上翻身或起卧是否反复出现短暂眩晕）在良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）诊断中的意义。方法详细记录2007年12月～2008年4月头晕门诊符合病史两问法的位置性眩晕患者138例,进行Dix-Hallpike及滚转试验明确诊断,和同期确诊的62例BPPV患者进行统计分析,明确病史两问法对诊断BPPV的敏感性和特异性。结果 138例主诉符合病史两问法的位置性眩晕患者中,除变位试验阴性的33例,105例变位试验中出现不同程度的眼震,并伴有眩晕主观感觉,其中符合贵阳会议BPPV标准者56例,病史两问法对诊断BPPV的敏感性为53.3%（56/105）。同期确诊的62例BPPV患者,其中56例符合病史两问法,6例为其他主诉,病史两问法诊断BPPV的特异性为90.3%（56/62）。结论病史两问法可以作为BPPV的筛查诊断方法,是一个简单实用的方法。

Significance of typical complaints in diagnosis of benign paroxysmal positional vertigo

OBJECTIVE To identify the validity of two-question method（repeated transient vertigo during roll or up and down on bed）for BPPV diagnosis. METHODS One hundred and thirty eight cases with the chief complaints of repeated transient vertigo during roll or up and down on bed during 2007.12～2008.4 were included in this study. Dix-Hallpike and roll test were selected as the golden standard method for diagnosis. The sensitivity and specificity of two-question method for screening diagnosis of BPPV were identified. RESULTS Of all 138 cases,33 cases presented negative in positioning test,105 cases presented positional nystagmus and vertigo,in which 56 cases fulfilled the Guiyang BPPV standard. The sensitivity of two-question method for screening diagnosis of BPPV was 53.3%（56/105）. During the same period,there were 62 identified BPPV cases presented in the clinic,56 cases were fitted with a history of two-question,6 cases with the other complaints,the specificity of two-question method for the diagnosis of BPPV was 90.3%（56/62）. CONCLUSION Twoquestions method was a simple and practical method for BPPV screening diagnosis.