本文選題：良性陣發(fā)性位置性眩暈　切入點：骨密度　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過對女性良性陣發(fā)性位置性眩暈患者的骨密度及雌二醇水平的測定,分析不同年齡段女性良性陣發(fā)性位置性眩暈患者的骨密度及雌二醇水平變化特點,探討女性良性陣發(fā)性位置性眩暈可能病因。方法與資料收集2015年10月-2017年2月就診于寧夏醫(yī)科大學(xué)總醫(yī)院及寧夏醫(yī)科大學(xué)心腦血管病醫(yī)院耳鼻咽喉頭頸外科眩暈患者的基本資料,最終測定80例診斷明確的住院女性良性陣發(fā)性位置性眩暈(Benign paroxysmal positional vertigo,BPPV)患者的骨密度(bone mineral density,BMD)、T值評分(T值為骨密度與年輕健康同性別人群比較得出)以及雌二醇(通常所說的雌激素主要指雌二醇)水平,收集寧夏醫(yī)科大學(xué)總醫(yī)院及寧夏醫(yī)科大學(xué)總醫(yī)院心腦血管病醫(yī)院集中健康體檢女性基本資料,最終納入52例健康對照組女性,收集其測得的骨密度、T值評分及雌二醇等相關(guān)資料。骨密度測定:利用雙能X線骨密度儀(Dual-energy X-ray absorptiometry,DXA)掃描受檢者腰椎。得出腰椎1,腰椎2,腰椎3,腰椎4的骨密度,骨密度以g/cm2為單位,T值為骨密度與年輕健康同性別人群比較得出。雌二醇水平測定:利用德國西門子公司ADVIA Centaur XP免疫分析儀ADVIA Centaur XP Enhanced Estradiol(e E2)競爭性免疫測定方法測得受檢者雌二醇水平。雌二醇單位為pg/ml,參考范圍:11.8-3000pg/ml,濾泡期(19.50-144.20),排卵期(63.90-356.70),黃體期(55.80-214.20),絕經(jīng)期(0.00-32.20)。根據(jù)中華醫(yī)學(xué)會婦產(chǎn)科學(xué)分會對女性生理周期變化特點的定義[31](絕經(jīng)前期:指性女性卵巢活動時期,包括青春期至絕經(jīng)期的一段時間;圍絕經(jīng)期:指絕經(jīng)過度期到最后1次月經(jīng)后1年,約45-55歲;絕經(jīng)后期:絕經(jīng)一直到生命終止的這段時間),對80例女性良性陣發(fā)性位置性眩暈患者進行分組:45歲分為絕經(jīng)前期組,45-55歲為圍絕經(jīng)期組,55歲為絕經(jīng)后期組。52例健康對照組女性同樣分為三小組。分析80例女性良性陣發(fā)性位置性眩暈患者不同年齡段骨密度、T值及雌二醇水平變化特點,對比不同年齡段女性良性陣發(fā)性位置性眩暈患者骨密度、T值及雌二醇水平與健康體檢者骨密度、T值及雌二醇水平是否存在差異。分析80例女性良性陣發(fā)性位置性眩暈患者骨密度、T值及雌二醇水平的相關(guān)性,以及52例健康體檢女性骨密度、T值和雌二醇水平的相關(guān)性分析。統(tǒng)計方法:結(jié)果以均數(shù)±標(biāo)準(zhǔn)差(X±SD)表示,BPPV組與對照組骨密度、T值和雌二醇水平統(tǒng)計學(xué)差異采用獨立樣本T檢驗,相關(guān)性分析采用積差相關(guān)Pearson相關(guān)性分析。統(tǒng)計軟件采用SPSS17.0。(P0.05)視為有統(tǒng)計學(xué)意義。結(jié)果80例BPPV女性,年齡34-78歲,平均年齡54.82±10.77歲,其中圍絕經(jīng)期和絕經(jīng)后期女性比例為:75%(60/80)。健康體檢對照組女性52例,年齡26-74歲,平均年齡51.78±12.45歲,其中圍絕經(jīng)期和絕經(jīng)后期女性比例為:73%(37/52)。兩組年齡獨立樣本t檢驗P=0.168,P0.05。BPPV組女性體質(zhì)指數(shù)(Body mass index,BMI)為23.99±2.52,對照組BMI為23.05±2.99,兩組BMI獨立樣本t檢驗P=0.052〉0.05。絕經(jīng)前期BPPV組(20/80)骨密度為1.0996±0.78g/cm2,對照組(14/52)骨密度為1.2476±0.14g/cm2,P=0.030.05。BPPV組T值為0.1800±0.96,對照組為1.1000±0.89,P=0.0250.05。BPPV組雌二醇為36.53±28.65pg/ml,對照組為75.36±23.15pg/ml,P=0.0020.05。圍絕經(jīng)期BPPV組(27/80)骨密度為0.9802±0.89g/cm2,對照組(16/52)骨密度為1.2132±0.84g/cm2,P=0.000.05。BPPV組T值為-1.1765±0.82,對照組為.7000±1.11,P=0.000.05。BPPV組雌二醇為23.67±10.02pg/ml,對照組為31.40±6.63pg/ml,P=0.0140.05。絕經(jīng)后期BPPV組(33/80)骨密度為0.9133±0.15g/cm2,對照組(22/52)骨密度為1.1879±0.14g/cm2,P=0.000.05。BPPV組T值為-1.8061±1.10,對照組為0.5273±1.03,P=0.000.05。BPPV組雌二醇為19.90±9.76pg/ml,對照組為28.56±7.26pg/ml,P=0.0010.05。80例BPPV組骨密度0.9596±0.16g/cm2,T值-1.2266±1.37,相關(guān)系數(shù)r=0.667,P=0.000.05;52例對照組骨密度1.2117±0.13g/cm2,T值0.7558±1.10,相關(guān)系數(shù)r=0.435,P=0.0010.05。80例BPPV組骨密度0.9596±0.16g/cm2,雌二醇22.8522±13.53pg/ml,相關(guān)系數(shù)r=0.337,P=0.0080.05;52例對照組骨密度1.2117±0.13g/cm2,雌二醇42.1494±24.12,相關(guān)系數(shù)r=0.279,P=0.0450.05。80例BPPV組T值-1.2266±1.37,雌二醇22.8522±13.53pg/ml,相關(guān)系數(shù)r=0.328,P=0.0100.05;52例對照組T值0.7558±1.10,雌二醇42.1494±24.12pg/ml,相關(guān)系數(shù)r=0.270,P=0.0530.05。結(jié)論1.絕經(jīng)前期、圍絕經(jīng)期、絕經(jīng)期女性良性陣發(fā)性位置性眩暈與骨密度下降有關(guān)。2.絕經(jīng)前期、圍絕經(jīng)期、絕經(jīng)期女性良性陣發(fā)性位置性眩暈與雌二醇水平下降有關(guān)。
[Abstract]:Objective to determine the bone density of patients with benign paroxysmal positional vertigo and estradiol levels in female, analysis of bone mineral density and estradiol levels change characteristics of different ages of female patients with benign paroxysmal positional vertigo, benign paroxysmal positional vertigo of women may cause. Methods and data collected in October 2015 -2017 year in February admitted to the basic data of the total hospital of Ningxia Medical University and Ningxia Medical University cardiovascular disease hospital of Otolaryngology Head and neck surgery patients with vertigo, the final determination of 80 cases of diagnosed female inpatients with benign paroxysmal positional vertigo (Benign paroxysmal positional vertigo, BPPV) and BMD (bone mineral density, BMD), T value (T value comparison as the bone density and young healthy gender) and estradiol (usually called estrogen estradiol level, mainly refers to the collection of Ningxia medical) Healthy women basic data cardio cerebrovascular disease hospital of General Hospital of University General Hospital and Ningxia Medical University, a total of 52 cases of healthy control group of women, the collected bone density measured by T score and estradiol and other relevant materials. The bone mineral density measurement by dual energy X-ray absorptiometry (Dual-energy X-ray absorptiometry. DXA scan) subjects. The 1 lumbar lumbar spine, 2 lumbar, lumbar 3, 4 lumbar bone density, bone mineral density in g/cm2, T values obtained for bone density and young healthy gender. Determination of estradiol level: the use of SIEMENS ADVIA Centaur XP ADVIA Centaur XP Enhanced Estradiol immune analyzer (E E2) measured by the test method for the determination of competitive immune levels of estradiol. Pg/ml, estradiol units for the reference range: 11.8-3000pg/ml, follicular phase (19.50-144.20), ovulation, luteal phase ((63.90-356.70) 55.80-214.20 ), menopause (0.00-32.20). According to the Chinese Medical Association Branch of Obstetrics and Gynecology change characteristics of female physiological cycle definition of [31] (premenopausal women: refers to the ovarian activity period, including adolescence and menopause for a period of time; this time: refers to the degree of perimenopausal period to 1 years after that, after about 1 last menstrual at the age of 45-55; postmenopause: menopause has been to the end of life), 80 cases of female patients with benign paroxysmal positional vertigo were divided into 45 groups: premenopausal group, aged 45-55 to 55 years old for perimenopausal group and postmenopausal group.52 healthy control group of women is also divided into three groups. Analysis of 80 cases of women benign paroxysmal positional vertigo patients in different age changes of bone density, T value and estradiol levels, bone mineral density in patients with different ages of female benign paroxysmal positional vertigo, T value and estradiol levels and healthy bone density, The value of T and estradiol levels. Whether there are differences in bone density analysis of 80 cases of female patients with benign paroxysmal positional vertigo, the correlation between T value and estradiol levels, and 52 cases of healthy female bone density, correlation analysis between T values and estradiol levels. Statistical methods: the mean standard deviation (X. SD) said, BPPV group and control group, bone mineral density, T value and estradiol levels statistically by independent samples T test, correlation analysis using Pearson correlation Pearson correlation analysis. The use of statistical software SPSS17.0. (P0.05) is regarded as statistically significant. Results 80 cases of BPPV women, age 34-78 years, mean age 54.82 + 10.77 among them, the proportion of women in perimenopausal and postmenopausal women: 75% (60/80). Healthy control group 52 cases were female, age 26-74 years, mean age 51.78 + 12.45 years, perimenopausal and postmenopausal women than for the cases: 73% (37/52) two years. The age of independent sample t test P=0.168, P0.05.BPPV group of female body mass index (Body mass index, BMI) was 23.99 + 2.52, 23.05 + 2.99 BMI control group, BMI group of two independent samples t test. 0.05. P=0.052 BPPV (20/80) in premenopausal group bone density was 1.0996 + 0.78g/cm2, the control group (14 /52) bone mineral density 1.2476 + 0.14g/cm2, P=0.030.05.BPPV group T = 0.1800 + 0.96 + 0.89, 1.1000 in the control group, P=0.0250.05.BPPV group of estradiol was 36.53 + 28.65pg/ml, the control group was 75.36 + 23.15pg/ml, P=0.0020.05. BPPV (27/80) in perimenopausal group bone density was 0.9802 + 0.89g /cm2, the control group (16/52) bone density was 1.2132 + 0.84g/cm2 P=0.000.05.BPPV, group T = -1.1765 + 0.82,.7000 + 1.11 for the control group, P=0.000.05.BPPV group, estradiol was 23.67 + 10.02pg/ml, the control group was 31.40 + 6.63pg/ml, P=0.0140.05. BPPV group (33/80) postmenopausal bone density was 0.9133 + 0.15g/cm2, the control group (22/52) Bone density was 1.1879 + 0.14g/cm2, group P=0.000.05.BPPV T = -1.8061 + 1.10, the control group is 0.5273 + 1.03, P=0.000.05.BPPV group of estradiol was 19.90 + 9.76pg/ml, the control group was 28.56 + 7.26pg/ml, P=0.0010.05.80 cases of BPPV bone mineral density was 0.9596 + 0.16g/cm2, T + 1.37 -1.2266, correlation coefficient r=0.667, P=0.000.05; 52 cases of control the bone mineral density was 1.2117 + 0.13g/cm2, T = 0.7558 + 1.10, the correlation coefficient r=0.435, P=0.0010.05.80 cases of BPPV bone mineral density was 0.9596 + 0.16g/cm2, 22.8522 + 13.53pg/ml estradiol, correlation coefficient r=0.337, P=0.0080.05; 52 cases of control group bone density was 1.2117 + 0.13g/cm2, 42.1494 + 24.12 estradiol, correlation coefficient r=0.279, P=0.0450.05.80 cases of BPPV group T the value of -1.2266 estradiol + 1.37, 22.8522 + 13.53pg/ml, the correlation coefficient r=0.328, P=0.0100.05; 52 cases in the control group T 0.7558 estradiol + 1.10, 42.1494 + 24.12pg/ml, the correlation coefficient r=0.270, P=0.0530.05. conclusion 1. Pre menopause, perimenopausal, menopausal women with benign paroxysmal positional vertigo and bone mineral density decrease are related to.2. premenopause, benign peri menopausal and menopausal women with benign paroxysmal positional vertigo are associated with decreased estradiol level.

【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R580;R764

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