良性阵发性位置性眩晕复发的影响因素分析

目的 探讨良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）复发的影响因素。 方法 收集2009年9月～2010年10月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科眩晕中心确诊并治疗的100例BPPV患者的资料，于诊治后12个月进行电话随访。对出现复发患者的年龄、性别、治疗方法、双温试验结果和共患颈椎病、高/低血压病、后循环缺血、高脂血症、糖尿病等情况比较，并采用二值Logistic回归分析BPPV复发的影响因素。 结果 年龄≥45岁的患者（38.89%）较年龄＜45岁的患者（14.29%）易复发（P=0.018）；血压异常［P=0.032，95%可信区间（confidence interval，CI）1.097～7.634，优势比（odds ratio，OR）=2.893］和非复位治疗（P=0.014，95%CI 1.261～7.940，OR 3.165）为BPPV复发的危险因素；性别、颈椎病、后循环缺血、高脂血症、糖尿病、双温试验异常与复发无显著相关。 结论 中老年BPPV患者易复发，血压异常和治疗方式与复发相关。

Analysis of the Factors Affecting Recurrence of Benign Paroxysmal Positional Vertigo

【Abstract】
Objective To investigate the factors affecting recurrence of benign paroxysmal positional vertigo(BPPV) patients.
Methods Hundred BPPV patients who were diagnosed and treated in Beijing Tongren Hospital of Capital Medical University from September 2009 to October 2010 were enrolled in our study. All the patients were followed up by phone call. The data of the patients including age, gender, modality of treatment, the result of bithermal caloric test, and co-morbidities (cervical spondylosis, hypotension or hypertension, posterior circulation ischemia, hyperlipidemia, diabetes) were analyzed. The factors affecting recurrence rate of BPPV were studied by applying χ2 test and the Logistic regression.
Results The recurrence rate of BPPV in older patients(38.89%) is higher than that in adolescents(14.29%)(P=0.018). Abnormal blood pressure(P=0.032, 95% confidence intervalCI]=1.097~7.634, odds ratioOR]=2.893) and non-reduction treatment for BPPV(P=0.014, 95%CI 1.261~7.940, OR 3.165) contributes significantly to recurrence; however there were no significant differences in cervical spondylosis, posterior circulation ischemia, hyperlipidemia, diabetes, and abnormal result of bithermal caloric test between both groups.
Conclusion Older patients are prone to recur. The factors affecting recurrence of BPPV include abnormal blood pressure and the modality of treatment.