良性阵发性位置性眩晕患者纯音听阈测试的研究

Study of Pure Tone Audiometry in Patients with Benign Paroxysmal Positional Vertigo

赵安琪;刘博;张祎;毕竞韬;段金萍;刘刚;

1:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科研究中心耳鼻咽喉科学重点实验室(教育部)北京市耳鼻咽喉科研究所

摘要

目的分析良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的纯音测听结果,探讨纯音测听在BPPV与其他眩晕疾病的鉴别诊断中的价值。方法符合诊断标准的单侧BPPV患者212例(年龄19～82岁,平均55.90±14.25岁),依据年龄分为老年组93例(≥60岁,平均68.26±6.46岁)和中青年组119例(<60岁,平均46.24±10.78岁);依据主诉分为主诉有听力损失组61例和主诉无听力损失组151例。对所有患者均行纯音测听检查,分析结果。结果 (1)212例BPPV患者中,听力正常(所有频率纯音听阈均在25dB HL以内)者79例(37.26%),听力损失133例(62.74%),其中高频听力损失68例(51.13%);老年组听力损失85例(63.91%),中青年组听力损失48例(36.09%),前者高于后者,差异有统计学意义(P<0.001)。(2)133例有听力损失患者中,主诉有听力损失组61例(28.77%),双耳下降27例,单耳下降34例,同侧BPPV25例(73.53%),对侧BPPV9例(26.47%);主诉无听力损失组72例,其中双耳下降65例,双耳听力损失程度一致者12例,听力损失较重耳与BPPV同侧32例,对侧21例;单耳下降7例,同侧BPPV5例,对侧BPPV2例。(3)61例主诉有听力损失患者中,25例与BPPV约同时发生,28例听力损失在BPPV之前发生,2例听力损失在BPPV之后发生,6例不确定。结论 BPPV患者中听力损失的发生率较高,且部分BPPV患者虽主诉无听力下降但纯音测听可检测出有听力损失;即使诊断明确的BPPV患者也应注重纯音听阈测试,以便更深入的进行针对性鉴别诊断,进而采取适当的干预措施。

关键词

良性阵发性位置性眩晕;纯音听阈测试;听力损失

基金项目(Foundation):

北京市科委健康培育项目(Z151100003915100);; 首都卫生科研发展专项(首发2016-3-1091)

作者

赵安琪;刘博;张祎;毕竞韬;段金萍;刘刚;

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