BPPV患者复位治疗后复发相关因素调查以及站立平衡功能分析
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邯郸市中心医院

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河北省医学科学研究课题(20211144)


Investigation of relapse related factors in PPV patients after reduction therapy and analysis of standing balance function
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    目的 探讨良性阵发性位置性眩晕(BPPV)患者复位治疗后复发的因素,分析BPPV患者站立平衡功能。方法 选择2019年2月至2020年12月我院耳鼻喉科收治的209例BPPV患者(BPPV组),所有患者手法复位治疗后均接受定期电话随访,根据随访期间是否发生复发将患者分为复发组(48例)和无复发组(161例)。通过收集临床资料,采用多因素Logistic回归分析BPPV复发的危险因素。选择60例体检者为对照组,采用感觉整合试验(SOT)评估动态站立平衡功能,采用感觉相互作用与平衡的改良临床试验(mCTSIB)评估静态站立平衡功能,并比较BPPV组累及不同半规管患者以及对照组间动态和静态站立平衡功能差异性。结果 复发组年龄≥50岁、女性、高血压、高脂血症、糖尿病、眩晕持续时间≥1周、复位次数≥3次比例高于无复发组(P<0.05)。多因素Logistic回归分析结果示年龄≥50岁、女性、糖尿病、高血压、高脂血症是BPPV手法复位后复发的危险因素(P<0.05)。BPPV组累及后半规管患者睁眼-测力板稳定-视景随动(CON3)、睁眼-测力板随动-视景稳定(CON4)、闭眼-测力板随动-视景稳定(CON5)、睁眼-测力板随动--视景随动(CON6)SOT平衡得分低于对照组(P<0.05),站立于海绵垫睁眼和闭眼时重心晃动的平均速度大于对照组(P<0.05)。结论 高龄、女性、高血压、高脂血症、糖尿病是BPPV手法复位后复发的危险因素,累及后半规管的BPPV患者容易发生站立平衡功能异常。

    Abstract:

    Objective To investigate the recurrence factors of benign paroxysmal positional vertigo (BPPV) after reduction therapy, and to analyze the standing balance function of BPPV patients. Methods 209 BPPV patients (BPPV group) admitted to the otolaryngology Department of our hospital from February 2019 to December 2020 were selected. All patients received regular telephone follow-up after manual reduction treatment, and were divided into recurrence group (48 cases) and non-recurrence group (161 cases) according to whether recurrence occurred during follow-up. By collecting clinical data, the risk factors for recurrence of BPPV were analyzed by multivariate Logistic regression. The sensory organization test (SOT) and the modified clinical test of sensory interaction and balance (mCTSIB) were used to evaluate static standing balance. The difference of dynamic and static standing balance function between BPPV patients with different semicircular canal involvement and control group was compared. Results The proportion of age ≥50 years old, female, hypertension, hyperlipidemia, diabetes, vertigo duration ≥1 week and reduction times ≥3 times in recurrence group were higher than those in non-recurrence group (P < 0.05). Multivariate Logistic regression analysis showed that age ≥50 years old, female, diabetes, hypertension and hyperlipidemia were risk factors for recurrence after manual reduction of BPPV (P < 0.05). The SOT balance score at open eyes - Force plate stability - Visual scene follow-up (CON3), Open eyes - Force plate follow-up - Visual scene stability (CON4), Closed eyes - Force plate follow-up - Visual scene stability (CON5), Open eyes - Force plate follow-up - Visual scene follow-up (CON6) in BPPV group with posterior canal involvement was lower than that in control group (P < 0.05), and the average velocity of center of gravity shaking when standing on sponge pad with eyes open and closed was higher than that in the control group (P < 0.05). Conclusion Advanced age, female, hypertension, hyperlipidemia and diabetes are risk factors for recurrence of BPPV after manual reduction. Patients with BPPV involving posterior semicircular canal are prone to abnormal standing balance function.

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  • 收稿日期:2021-11-26
  • 最后修改日期:2022-03-30
  • 录用日期:2022-04-11
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