中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
4期
355-358
,共4页
岳伟%相蕾%张雅静%纪勇
嶽偉%相蕾%張雅靜%紀勇
악위%상뢰%장아정%기용
眩晕%脑血管障碍
眩暈%腦血管障礙
현훈%뇌혈관장애
Vertigo%Cerebrovascular disorders
目的 探讨血管病变在老年人良性阵发性位置性眩晕(BPPV)的发病中的作用. 方法 将我院就诊的≥60岁老年人中良性阵发性位置性眩晕74例患者设为病例组,随机选取同期我院体检中心的无眩晕史的80例体检者作为对照组.利用高分辨力双功能超声进行颈动脉血管超声检查,比较两组间颈内动脉管壁内膜-中膜厚度和颈动脉附壁斑块检出率,作为判断大血管病变的指标.同时,利用3.0T高场强核磁共振进行头颅T1WI、T2WI常规序列和磁敏感加权成像序列扫描,比较两组间腔隙性梗死、脑白质疏松、微出血的严重程度,作为判断小血管病变的指标.两类指标结合对比分析病例组和对照组中颅内外大、小血管病变的不同. 结果 病例组和对照组比较,颈内动脉内膜-中膜厚度分别为(0.96±0.21)mm和(0.84±0.26)mm(t=3.136,P＜0.05),颈动脉附壁斑块检出率分别为89.2％和72.5％(x2=5.803,P＜0.05),腔隙性梗死灶数量为(3.48±1.67)个和(2.34±2.06)个(t=1.994,P＜0.05),脑白质疏松评分为(4.77±2.15)分和(3.95±2.04)分(t=2.430,P＜0.05),两组间差异有统计学意义.脑内微出血的阳性检出率分别为22.9％和17.5％(x2=0.4264,P＞0.05),差异无统计学意义. 结论 老年人良性阵发性位置性眩晕与颅内外大血管、小血管病变均有相关性,推断在老年人良性阵发性位置性眩晕的发病中血管因素可能起到了重要作用.
目的 探討血管病變在老年人良性陣髮性位置性眩暈(BPPV)的髮病中的作用. 方法 將我院就診的≥60歲老年人中良性陣髮性位置性眩暈74例患者設為病例組,隨機選取同期我院體檢中心的無眩暈史的80例體檢者作為對照組.利用高分辨力雙功能超聲進行頸動脈血管超聲檢查,比較兩組間頸內動脈管壁內膜-中膜厚度和頸動脈附壁斑塊檢齣率,作為判斷大血管病變的指標.同時,利用3.0T高場彊覈磁共振進行頭顱T1WI、T2WI常規序列和磁敏感加權成像序列掃描,比較兩組間腔隙性梗死、腦白質疏鬆、微齣血的嚴重程度,作為判斷小血管病變的指標.兩類指標結閤對比分析病例組和對照組中顱內外大、小血管病變的不同. 結果 病例組和對照組比較,頸內動脈內膜-中膜厚度分彆為(0.96±0.21)mm和(0.84±0.26)mm(t=3.136,P＜0.05),頸動脈附壁斑塊檢齣率分彆為89.2％和72.5％(x2=5.803,P＜0.05),腔隙性梗死竈數量為(3.48±1.67)箇和(2.34±2.06)箇(t=1.994,P＜0.05),腦白質疏鬆評分為(4.77±2.15)分和(3.95±2.04)分(t=2.430,P＜0.05),兩組間差異有統計學意義.腦內微齣血的暘性檢齣率分彆為22.9％和17.5％(x2=0.4264,P＞0.05),差異無統計學意義. 結論 老年人良性陣髮性位置性眩暈與顱內外大血管、小血管病變均有相關性,推斷在老年人良性陣髮性位置性眩暈的髮病中血管因素可能起到瞭重要作用.
목적 탐토혈관병변재노년인량성진발성위치성현훈(BPPV)적발병중적작용. 방법 장아원취진적≥60세노년인중량성진발성위치성현훈74례환자설위병례조,수궤선취동기아원체검중심적무현훈사적80례체검자작위대조조.이용고분변력쌍공능초성진행경동맥혈관초성검사,비교량조간경내동맥관벽내막-중막후도화경동맥부벽반괴검출솔,작위판단대혈관병변적지표.동시,이용3.0T고장강핵자공진진행두로T1WI、T2WI상규서렬화자민감가권성상서렬소묘,비교량조간강극성경사、뇌백질소송、미출혈적엄중정도,작위판단소혈관병변적지표.량류지표결합대비분석병례조화대조조중로내외대、소혈관병변적불동. 결과 병례조화대조조비교,경내동맥내막-중막후도분별위(0.96±0.21)mm화(0.84±0.26)mm(t=3.136,P＜0.05),경동맥부벽반괴검출솔분별위89.2％화72.5％(x2=5.803,P＜0.05),강극성경사조수량위(3.48±1.67)개화(2.34±2.06)개(t=1.994,P＜0.05),뇌백질소송평분위(4.77±2.15)분화(3.95±2.04)분(t=2.430,P＜0.05),량조간차이유통계학의의.뇌내미출혈적양성검출솔분별위22.9％화17.5％(x2=0.4264,P＞0.05),차이무통계학의의. 결론 노년인량성진발성위치성현훈여로내외대혈관、소혈관병변균유상관성,추단재노년인량성진발성위치성현훈적발병중혈관인소가능기도료중요작용.
Objective To explore the relationship between vascular lesions and benign paroxysmal positional vertigo in the elderly.Methods 74 patients aged 60 years and over with benign paroxysmal positional vertigo in Huanhu Hospital and 80 subjects without vertigo history in the medical examination center of the same hospital were randomly divided into the case group and the control group,respectively.The carotid intima-media thickness (CIMT) and plaque in the carotid artery were detected using high-resolution color duplex ultrasound for evaluating large vascular lesions.At the same time,T1WI,T2WI and diffusion weighted imaging (DWI) were performed with high-field 3.0 T MRI scanner as the detection index of small vascular lesions to compare the difference in severity of lacunar infarction,leukoaraiosis and micro hemorrhage between the two groups.Both indexes were used together to compare the overall difference in the intracranial and extracranial vascular lesions between the two groups.Results Between the case group and the control group,there were significant differences in the CIMT [(0.96±0.21) mm vs.(0.84±0.26) mm,t=3.136,P＜0.05],the detection rate of plaque (89.2％ vs.72.5％,x2 =5.803,P＜0.05),the number of lacunar infarction [(3.48± 1.67) vs.(2.34± 2.06),t=1.994,P＜0.05] and the score of white matter [(4.77±2.15) vs.(3.95±2.04),t=2.430,P＜0.05].There was no significant difference in the positive detection rate of the cerebral microbleeds in the case group and control group (22.9％ vs.17.5％,x2=0.4264,P＞0.05).Conclusions There is a relationship between the benign paroxysmal positional vertigo and intracranial or extracranial vascular lesions in the elderly.Vascular factor may play an important role in the pathogenesis of benign paroxysmal positional vertigo.Not only the atherosclerosis of large and small arteries but also the microcirculation disturbance may be partly attributed to the benign paroxysmal positional vertigo in the elderly.
