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在老年患者中成功重新定位后残留头的危险因素,这些患者患有良性发性定位头

Jun Yan¹, Bo Yao², Ya-Ya Gao¹

¹Department of Neurology, Xi 'an Fifth Hospital, Xi'an, Shaanxi Province, China.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

|February 18, 2025

概括

在老年患者治疗良性偏激性位置性 (BPPV) 后,残留的头与较低的骨矿物质密度和脑血管反应能力的降低有关. 这些因素,以及白质病变,有助于预测短期结果.

科学领域:

老年医学老年医学
神经学神经学
耳鼻喉科耳鼻喉科耳鼻喉科

背景情况:

良性发性位置性 (BPPV) 是老年人头的常见原因之一.
在成功地手动减少BPPV后,残留性头 (RD) 可能会持续存在,影响生活质量.
在老年BPPV患者中导致短期RD的因素需要进一步调查.

研究的目的:

为了研究影响老年患者残留头 (RD) 的因素,在成功手动减少良性发性定位头 (BPPV) 之后.
评估骨矿物质密度 (BMD),大脑血流和大脑白质在短期RD中的作用.
评估RD特定临床和成像标志物的预测价值.

主要方法:

112名老年BPPV患者接受了头障碍库存 (DHI) 的评估,骨矿物质密度 (BMD) 通过T-score,大脑血流 (Vm, PI) 的跨皮多普勒 (TCD),通过呼吸持久指数 (BHI) 的脑血管反应 (CVR) 和白质病变 (LA-score) 的头骨MRI.
患者在减少后一周被分为残留头 (RD) 和非RD组.
进行了统计分析,包括多变量逻辑回归和ROC曲线分析,以确定风险因素并评估诊断效率.

主要成果:

与非RD组相比,RD组的DHI和LA分数显著更高,T分数和BHI较低 (P <0.05).
降低BHI和T-score,增加DHI和LA-score被确定为短期RD的风险因素.
多变量分析证实BHI,T-score和LA-score是独立的风险因素. 综合分析得出高AUC为0.842 (灵敏度为70.73%,特异性为90.14%).

结论:

降低BHI和T-score,增加DHI和LA-score是老年BPPV患者减少后短期RD的重要危险因素.
BHI,T-score和LA-score是RD的独立预测指标,联合评估提供了优越的预测价值.
在BPPV管理后预测短期的RD,BMD,CVR和白质完整性至关重要.

关键词:

良性发性定位性头.骨密度骨密度骨密度骨密度大脑血管反应活性年长的老人.这是一种白血病性白血病症 (leukoaraiosis).剩余的头可能会导致头.

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