良性阵发性位置性眩晕的单中心临床分析

doi:10.3969/j.issn.1004-583X.2025.08.004

摘要/Abstract

摘要：

目的分析良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的临床特征。方法选取2021年2月-2024年11月华侨大学附属厦门长庚医院神经内科门诊收治的BPPV患者339例,并回顾性分析其临床特征。结果男性138例(40.7%),女性201例(59.3%),男女比例为1∶1.5。平均年龄(49.6±6.5)岁。发病高峰年龄为40~49岁。155例(45.7%)既往有类似发作。后半规管BPPV 210例(61.9%);水平半规管BPPV 118例(34.8%),其中水平半规管管结石型91例(77.1%),嵴帽结石型27例(22.9%)。手法复位总有效率99.6%。210例有随访资料,随访时间1~33个月,复发45例,复发率21.4%。结论 BPPV发病年龄有年轻化趋势;受累半规管类型以后半规管BPPV居多;BPPV的手法复位效果显著。

关键词: 良性阵发性位置性眩晕, 临床分型, 手法复位

Abstract:

Objective To analyze the clinical features of benign paroxysmal positional vertigo (BPPV). Methods From February 2021 to November 2024, 339 BPPV patients diagnosed and treated in the Department of Neurology, Xiamen Chang Gung Hospital, Huaqiao University, were selected as the subjects. The clinical data were analyzed retrospectively. Results There were 138 (40.7%) males and 201 (59.3%) females, with the male-to-female ratio of 1∶1.5. The mean age was 49.6±6.5 years. A total of 155 patients (45.7%) had similar attacks in the past. The peak age of onset was 40-49 years. Classified by the clinical types, there were 210 (61.9%) cases of posterior semicircular canal BPPV, and 118 (34.8%) cases of horizontal semicircular canal BPPV, including canalolithiatic type in 91 (77.1%) cases and cupulolithiatic in 27 (22.9%) cases. The overall effectiveness rate of canalith repositioning maneuver was 99.6%. Among the 210 cases with follow-up data, the follow-up period ranged from 1 to 33 months. There were 45 cases of recurrence, with the recurrence rate of 21.4%. Conclusion The age of BPPV onset is trending younger. Posterior semicircular canal BPPV is the most common clinical type. The effectiveness rate of canalith repositioning maneuver of BPPV is high.

Key words: benign paroxysmal positional vertigo, clinical classification, canalith repositioning maneuver

中图分类号:

R764.33

邹亚芬, 贾晓燕, 戴翠招. 良性阵发性位置性眩晕的单中心临床分析[J]. 临床荟萃, 2025, 40(8): 694-697.

Zou Yafen, Jia Xiaoyan, Dai Cuizhao. A single-center clinical analysis of benign paroxysmal positional vertigo[J]. Clinical Focus, 2025, 40(8): 694-697.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2025.08.004

https://www.lchc.cn/CN/Y2025/V40/I8/694

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项目	例数(例)	占比(%)
头部外伤史	24	7.1
既往类似病史	155	45.7
骨折史	1	0.3
中耳炎	9	2.6
合并高血压	26	7.7
糖尿病	6	1.8
高脂血症	10	2.9
冠状动脉粥样硬化性心脏病	6	1.8
偏头痛	11	3.2

项目	例数(例)	占比(%)
头部外伤史	24	7.1
既往类似病史	155	45.7
骨折史	1	0.3
中耳炎	9	2.6
合并高血压	26	7.7
糖尿病	6	1.8
高脂血症	10	2.9
冠状动脉粥样硬化性心脏病	6	1.8
偏头痛	11	3.2

组别	例数		左侧	右侧
后半规管	210		85(40.5)	125(59.5)
水平半规管	118		44(37.3)	74(62.7)
χ²值		0.267
P值		0.605

组别	例数		左侧	右侧
后半规管	210		85(40.5)	125(59.5)
水平半规管	118		44(37.3)	74(62.7)
χ²值		0.267
P值		0.605

类型	复位例数 (例)	单次复位 (例)	单次复位有效率 (%)	2次以上复位 (例)	2次以上复位有效率(%)	未复位 (例)	合计 (例)
后半规管BPPV	193	174	90.1	19	100.0	17	210
水平半规管BPPV	102	95	93.1	7	100.0	16	118
前半规管BPPV	1	0	0	1	100.0	1	2
不确定型	8	4	50.0	3	87.5	1	9
合计	304	273	89.8	30	99.6	35	339