血清维生素D和甲状旁腺激素水平及骨密度变化与良性阵发性位置性眩晕的相关性
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摘要
目的:检测良性阵发性位置性眩晕(BPPV)患者血清25-羟基维生素D[25-(OH)_2-VitD_3]、甲状旁腺激素(PTH)水平及骨密度变化,并分析其与BPPV的相关性。方法:选取BPPV患者50例(BPPV组),同期体检健康人50例为对照组,采用化学发光法检测血清维生素D水平,采用化学发光免疫分析法检测血清PTH水平,利用双能X线骨密度仪检测2组患者腰椎1～4的骨密度T值。结果:BPPV组患者血清25-(OH)_2-VitD_3水平显著低于对照组(P<0.05);BPPV组患者血清PTH水平显著高于对照组(P<0.05);男性和<48岁女性BPPV患者T值与对照组相比差异无统计学意义(P>0.05),≥48岁女性BPPV患者T值显著小于对照组(P<0.05)。Logistic回归分析结果显示,血清25-(OH)_2-VitD_3水平降低、PTH水平升高、骨密度降低是BPPV发生的危险因素。结论:BPPV患者血清25-(OH)_2-VitD_3水平降低,PTH水平升高,骨密度降低,是BPPV的危险因素。
Objective: To detect serum 25-hydroxyvitamin D [25-(OH)_2-VitD_3], parathyroid hormone(PTH), and bone mineral density in patients with benign paroxysmal positional vertigo(BPPV), and to analyze their correlations with BPPV. Method: Fifty cases of BPPV were selected as the study group, 50 healthy persons were selected as control group. Chemiluminescence assay was used to detect serum VD level, chemiluminescence immunoassay was used to detect serum PTH level, dual energy X-ray absorptiometry was used to detect bone mineral density(BMD) and T value of lumbar vertebrae 1 to lumbar vertebrae 4 in two groups. Result: The serum 25-(OH)_2-VitD_3level in the study group was significantly lower than that in the control group(P<0.05); the serum PTH level of the study group was significantly higher than that of the control group(P<0.05); there was no significant difference in T value between male BPPV patients and female BPPV patients younger than 48 years old with the control group(P>0.05), T value of female BPPV patients older than 48 years old was significantly lower than that of the control group(P<0.05). Logistic regression analysis showed that the decrease of serum 25-(OH)_2-VitD_3 level, the increase of PTH level, and the decrease of bone mineral density were risk factors for BPPV. Conclusion: The level of serum 25-(OH) _2-VitD_3is decreased in BPPV patients, PTH level is increased and bone mineral density is decreased, they are risk factors for BPPV.
Objective: To detect serum 25-hydroxyvitamin D [25-(OH)_2-VitD_3], parathyroid hormone(PTH), and bone mineral density in patients with benign paroxysmal positional vertigo(BPPV), and to analyze their correlations with BPPV. Method: Fifty cases of BPPV were selected as the study group, 50 healthy persons were selected as control group. Chemiluminescence assay was used to detect serum VD level, chemiluminescence immunoassay was used to detect serum PTH level, dual energy X-ray absorptiometry was used to detect bone mineral density(BMD) and T value of lumbar vertebrae 1 to lumbar vertebrae 4 in two groups. Result: The serum 25-(OH)_2-VitD_3level in the study group was significantly lower than that in the control group(P<0.05); the serum PTH level of the study group was significantly higher than that of the control group(P<0.05); there was no significant difference in T value between male BPPV patients and female BPPV patients younger than 48 years old with the control group(P>0.05), T value of female BPPV patients older than 48 years old was significantly lower than that of the control group(P<0.05). Logistic regression analysis showed that the decrease of serum 25-(OH)_2-VitD_3 level, the increase of PTH level, and the decrease of bone mineral density were risk factors for BPPV. Conclusion: The level of serum 25-(OH) _2-VitD_3is decreased in BPPV patients, PTH level is increased and bone mineral density is decreased, they are risk factors for BPPV.
引文
[1] 张加良,惠莲.良性阵发性位置性眩晕的发病特征及复位治疗后短期残余症状的影响因素分析[J].临床耳鼻咽喉头颈外科杂志,2018,32(13):1016-1019.
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[14] 田志,杨召旭,范静,等.老年骨折患者血清25OHD和PTH水平与骨质疏松程度的相关性[J].重庆医学,2018,47(6):767-769.
[15] 张萌萌.甲状旁腺素的生物学研究与成骨作用[J].中国骨质疏松杂志,2017,23(12):1648-1653.
[16] 冯雨来,张杰,代政学,等.维生素D与PTH相关性研究进展[J].现代生物医学进展,2017,17(2):385-388.
[17] 翟秀云,刘博,张玉和,等.良性阵发性位置性眩晕患者的骨密度研究与分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(23):1865-1869.
[18] LIU P,GUPTA N,JING Y,et al.Further Studies of the Effects of Aging on Arginine Metabolites in the Rat Vestibular Nucleus and Cerebellum[J].Neuroscience,2017,348:273-287.
[19] 林杭,郝毅,赵正旭,等.不同年龄男性骨质疏松症患者骨密度及骨代谢指标的变化研究[J].中国卫生检验杂志,2018,28(1):74-78.
[20] 冯娟娟,程泽星,沈永华.突发性耳聋继发良性阵发性位置性眩晕的相关发病因素分析[J].中国医药导刊,2017,19(10):1002-1005.
[2] 闫亚平,张淑香.特发性良性阵发性位置性眩晕发病危险因素研究进展[J].中国中西医结合耳鼻咽喉科杂志,2017,25(5):392-395.
[3] 于新军,孙宝梅.良性阵发性位置性眩晕病因学研究[J].北京医学,2017,39(8):770-773.
[4] 顾湘,董飞林,顾建华.良性阵发性位置性眩晕患者血清25羟维生素D水平研究[J].临床耳鼻咽喉头颈外科杂志,2017,31(12):924-926.
[5] 吴子明,王丹丹.国际巴拉尼学会BPPV诊断新标准解读及2007版美国耳鼻咽喉头颈外科学会BPPV诊疗指南更新要点[J].听力学及言语疾病杂志,2017,25(5):448-449.
[6] 卫旭东.良性阵发性位置性眩晕诊治进展[J].临床耳鼻咽喉头颈外科杂志,2016,30(5):345-348.
[7] TIRELLI G,NICASTRO L,GATTO A,et al.Repeated canalith repositioning procedure in BPPV:Effects on recurrence and dizziness prevention[J].Am J Otolaryngol,2017,38:38-43.
[8] KORKMAZ M,KORKMAZ H.Cases requiring increased number of repositioning maneuvers in benign paroxysmal positional vertigo[J].Braz J Otorhinolaryngol,2016,82:452-457.
[9] KARATA? A,ACAR Y G,YüCE T,et al.Association of benign paroxysmal positional vertigo with osteoporosis and vitamin D deficiency:a case controlled study[J].J Int Adv Otol,2017,13:259-265.
[10] 林上进,程群,邵云潮,等.血骨代谢指标及骨密度与骨组织钙、磷及金属微量元素含量的相关性[J].中华骨质疏松和骨矿盐疾病杂志,2017,10(6):513-518.
[11] MEGHJI S,MURPHY D,NUNNEY I,et al.The seasonal variation of benign paroxysmal positional vertigo[J].Otol Neurotol,2017,38:1315-1318.
[12] 陈志凌,陈艳春,吴华为,等.良性阵发性位置性眩晕手法复位并发耳石异常移位的临床分析[J].中国耳鼻咽喉头颈外科,2016,23(12):691-695.
[13] MAHBOOBEH S,YONES L,ABDOLLAH M,et al.Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo:a longitudinal clinical study[J].Caspian J Intern Med,2016,7:93-98.
[14] 田志,杨召旭,范静,等.老年骨折患者血清25OHD和PTH水平与骨质疏松程度的相关性[J].重庆医学,2018,47(6):767-769.
[15] 张萌萌.甲状旁腺素的生物学研究与成骨作用[J].中国骨质疏松杂志,2017,23(12):1648-1653.
[16] 冯雨来,张杰,代政学,等.维生素D与PTH相关性研究进展[J].现代生物医学进展,2017,17(2):385-388.
[17] 翟秀云,刘博,张玉和,等.良性阵发性位置性眩晕患者的骨密度研究与分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(23):1865-1869.
[18] LIU P,GUPTA N,JING Y,et al.Further Studies of the Effects of Aging on Arginine Metabolites in the Rat Vestibular Nucleus and Cerebellum[J].Neuroscience,2017,348:273-287.
[19] 林杭,郝毅,赵正旭,等.不同年龄男性骨质疏松症患者骨密度及骨代谢指标的变化研究[J].中国卫生检验杂志,2018,28(1):74-78.
[20] 冯娟娟,程泽星,沈永华.突发性耳聋继发良性阵发性位置性眩晕的相关发病因素分析[J].中国医药导刊,2017,19(10):1002-1005.