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良性阵发性位置性眩晕残留症状的影响因素
童蓓周丽丽庄建华赵忠新
0
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摘要:
目的 探讨良性阵发性位置性眩晕(BPPV)患者耳石复位后残留症状的影响因素。方法 本 研究为前瞻性研究,共收集42例门诊确诊BPPV的患者在发病时和耳石复位成功1周后的一般情况,以 及眩晕残障量表(DHI)、医院焦虑抑郁量表(HADS)和眼肌前庭诱发肌源性电位检查(oVEMP)的结果。按 照复位成功后有无残留症状进行分组比较,Logistic回归分析残留症状的影响因素。结果 41例患者完 成随访,发现12例(29.3%)患者耳石复位成功后出现残留症状。残留症状组平均年龄和病程均大于无残 留症状组(P< 0.05);残留症状组oVEMP患侧的振幅在耳石复位后有明显增高(P< 0.05);残留症状组的 DHI-E(情绪)和HADS总分均高于无残留症状组(P < 0.01)。进行Logistic回归分析发现BPPV发病时的 情绪状态是复位后残留症状的独立危险因素(P<0.05)。结论 BPPV复位后残留症状受多方面因素影响, 抑郁与焦虑情绪是主要影响因素,BPPV发病时心理情绪干预能预防或改善残留症状的发生。
关键词:  良性阵发性位置性眩晕  前庭诱发肌源性电位  抑郁  焦虑  残留症状
DOI:10.3969/j.issn.1009-6574.2017.11.012
基金项目:
Factors related to residual symptoms of benign paroxysmal positional vertigo
()
Abstract:
Objective To explore the influencing factors of residual symptoms after successful repositioning maneuvers in benign paroxysmal positional vertigo( BPPV). Methods The paper was a prospective study including 42 patients diagnosed with BPPV who were admitted to the dizziness outpatient department of Shanghai Changzheng Hospital. A variety of data were collected, including the general medical history of both onset and one week after successful repositioning maneuvers and the results of Dizziness Handicap Inventory (DHI), Hospital Anxiety Depression Scale( HADS) and ocular vestibular evoked myogenic potentials( o-VEMP). Patients were categorized into two groups according to the presence or absence of residual symptoms after successful repositioning maneuvers. Logistic regression analysis was used to determine the factors affecting the residual symptoms. Results A total of 41 patients completed the follow-up investigation, 12(29.3%) of which presented residual dizziness one week after successful repositioning maneuvers. The average age and duration of vertigo of the residual symptoms group were all higher than those of the non-residual symptoms group( P<0.05). A significantly higher amplitude of o-VEMP was observed in patients with residual dizziness after successful repositioning maneuvers than those without( P< 0.05). Patients with residual dizziness presented a higher DHI-E( Emotion) score and a higher HADS score than the patients in the non-residual symptoms group( P<0.01). The Logistic regression analysis revealed that the emotional state during onset was an independent risk factor for residual dizziness after successful repositioning maneuvers( P < 0.05). Conclusions The residual dizziness in BPPV is affected by various factors, with anxiety and depression being the major factors. Intervention of psychological state for BPPV patients during onset might prevent or alleviate the occurrence of residual dizziness.
Key words:  Benign paroxysmal positional vertigo  Vestibular evoked myogenic potential  Depression  Anxiety  Residual dizziness

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