目的:比较临床特征,危险因素,良性阵发性位置性眩晕(BPPV)亚型的分布,老年和非老年BPPV患者的耳石重新定位的有效性。
方法:共纳入400例BPPV患者。根据所涉及的半规管进行Canalith重新定位。患者按年龄分为老年组(≥60岁)和非老年组(20-59岁)。临床特征,潜在的年龄相关危险因素,亚型的分布,两组之间比较了耳石重新定位的有效性。
结果:女性在所有年龄组中明显更常见,在50-59岁的人群中,男女比例最高为5.1:1。老年组中男性比例较高。与动脉粥样硬化相关的病史在老年组中明显更常见(p<0.05)。偏头痛在非老年组明显更常见(p=0.018),后管BPPV也是如此。水平管BPPV(尤其是水平管BPPV-铜管结石),多肛门BPPV亚型在老年组中更常见,而前管BPPV在非老年组更为常见。在58.0%的老年病例和72.6%的非老年病例中,两次耳石重新定位有效(p=0.002)。随着年龄的增长,耳石重新定位的有效性有降低的趋势。
结论:BPPV在女性中更为常见。然而,男性BPPV比例随年龄增长而增加。老年患者通常有与动脉粥样硬化相关的疾病病史(即,高血压,糖尿病,和高脂血症)。在老年患者中,水平管BPPV(尤其是水平管BPPV-铜管结石)和多肛门BPPV亚型更为常见,前管BPPV亚型较少见。耳石重新定位的有效性可能会随着年龄的增长而降低。因此,老年患者应接受更全面的治疗。
方法:
OBJECTIVE: To compare the clinical features, risk factors, distribution of Benign Paroxysmal Positional Vertigo (BPPV) subtypes, and effectiveness of canalith repositioning between geriatric and non-geriatric patients with BPPV.
METHODS: A total of 400 patients with BPPV were enrolled. Canalith repositioning was performed according to the semicircular canals involved. Patients were divided by age into a geriatric group (≥60 years) and a non-geriatric group (20-59 years). Clinical characteristics, potential age-related risk factors, distribution of subtypes, and effectiveness of canalith repositioning were compared between the groups.
RESULTS: Female sex was significantly more common in all age groups, with a peak female-to-male ratio of 5.1:1 in the group aged 50-59 years. There was a higher proportion of men in the geriatric group. A history of disease associated with atherosclerosis was significantly more common in the geriatric group (p < 0.05). Migraine was significantly more common in the non-geriatric group (p = 0.018), as was posterior canal BPPV. The horizontal canal BPPV (especially horizontal canal BPPV-
cupulolithiasis), and multicanal BPPV subtypes were more common in the geriatric group, whereas anterior canal BPPV was more common in the non-geriatric group. Two canalith repositioning sessions were effective in 58.0% of the geriatric cases and in 72.6% of the non-geriatric cases (p = 0.002). There was a tendency for the effectiveness of canalith repositioning to decrease with increasing age.
CONCLUSIONS: BPPV was more common in women. However, the proportion of men with BPPV increased with age. Elderly patients often had a history of diseases associated with atherosclerosis (i.e., hypertension, diabetes, and hyperlipidemia). The horizontal canal BPPV (particularly horizontal canal BPPV-
cupulolithiasis) and multicanal BPPV subtypes were more common and the anterior canal BPPV subtype was less common in elderly patients. The effectiveness of canalith repositioning may decrease with age. Therefore, older patients should receive more comprehensive medical treatment.
METHODS: