【摘要】：目的：本研究通過(guò)對(duì)特發(fā)性面神經(jīng)麻痹（BP）患者的發(fā)病相關(guān)因素進(jìn)行分析，，為BP的預(yù)防提供依據(jù)。 方法：收集2009年1月-2013年8月吉林大學(xué)第二醫(yī)院神經(jīng)內(nèi)科門(mén)診及住院治療的BP患者共160例，體檢中心健康體檢者160例作為對(duì)照組；對(duì)其病史、既往史、個(gè)人史、血壓、頭部CT或MRI、血脂、血糖、一般內(nèi)科體征及神經(jīng)系統(tǒng)體征等進(jìn)行收集，以年齡、性別、高血壓、高脂血癥、糖尿病、受涼、外耳道皰疹、吸煙史、飲酒史這9項(xiàng)為對(duì)象，探討其與BP發(fā)病的相關(guān)性。對(duì)其中21例BP者、以非BP且排除耳部疾病者為對(duì)照組，進(jìn)行顳骨內(nèi)耳顱底CT檢查，應(yīng)用圖像重建技術(shù)行多平面重建(MPR)及曲面重建(CPR)。測(cè)量BP者患側(cè)、健側(cè)、對(duì)照組與BP者患側(cè)的相應(yīng)側(cè)（文章中簡(jiǎn)稱(chēng)為對(duì)照組相應(yīng)側(cè)）面神經(jīng)管各段（迷路段、水平段、垂直段）的最小管徑、各段是否存在裂缺、各段周?chē)欠翊嬖谘装Y，探討B(tài)P發(fā)病與面神經(jīng)管發(fā)育的關(guān)系。統(tǒng)計(jì)分析采用SAS數(shù)據(jù)分析包，對(duì)BP發(fā)病與年齡的關(guān)系比較使用t檢驗(yàn)，BP發(fā)病與性別的關(guān)系、BP發(fā)病與各發(fā)病可能相關(guān)因素的關(guān)系比較使用2檢驗(yàn)，各發(fā)病可能相關(guān)因素之間的關(guān)系比較使用Logistics回歸，BP發(fā)病與面神經(jīng)管各段最小管徑的關(guān)系比較使用假設(shè)檢驗(yàn)（正態(tài)性檢驗(yàn)、t檢驗(yàn)），BP發(fā)病與各段是否存在裂缺、各段周?chē)欠翊嬖谘装Y的關(guān)系比較使用2檢驗(yàn)。P＜0.05顯示有統(tǒng)計(jì)學(xué)意義。 結(jié)果： ①單因素分析顯示，受涼、外耳道皰疹、高脂血癥、飲酒史均與BP的發(fā)病有關(guān)（P0.05）。 ②多因素分析（Logistics回歸）顯示，受涼、外耳道皰疹、高脂血癥均為BP發(fā)病的危險(xiǎn)因素，相關(guān)性大小依次為：受涼外耳道皰疹高脂血癥。飲酒史為BP發(fā)病的保護(hù)因素，無(wú)顯著致病作用。 ③假設(shè)檢驗(yàn)（正態(tài)性檢驗(yàn)、t檢驗(yàn)）顯示，BP患者患側(cè)面神經(jīng)管各段最小管徑均小于健側(cè)；對(duì)照組相應(yīng)側(cè)的面神經(jīng)管迷路段、水平段最小管徑較患者健側(cè)無(wú)明顯差別，但垂直段較患者健側(cè)大。 ④單因素分析顯示，面神經(jīng)管水平段裂缺、垂直段裂缺、水平段周?chē)装Y與BP的發(fā)病有關(guān)（P0.05）。 ⑤本組病例中BP患者的復(fù)發(fā)率為7.5%。 結(jié)論：受涼、外耳道皰疹、高脂血癥均為BP發(fā)病的危險(xiǎn)因素，相關(guān)性大小依次為：受涼外耳道皰疹高脂血癥。面神經(jīng)管迷路段最小管徑、水平段最小管徑、水平段裂缺、垂直段裂缺、水平段周?chē)装Y均與BP的發(fā)病有關(guān)。而B(niǎo)P發(fā)病與年齡、性別、高血壓、吸煙史、飲酒史、面神經(jīng)管垂直段最小管徑無(wú)關(guān)。
[Abstract]:Objective: to analyze the related factors of (BP) patients with idiopathic facial paralysis and to provide evidence for BP prevention. Methods: from January 2009 to August 2013, 160 BP patients treated in Department of Neurology, second Hospital of Jilin University, and 160 healthy persons in physical examination center were collected as control group, their medical history, past history, personal history, blood pressure, blood pressure and blood pressure. Head CT or MRI, blood lipids, blood glucose, general medical signs and neurological signs were collected. Nine items were collected, including age, sex, hypertension, hyperlipidemia, diabetes, cold, external ear canal herpes, smoking history, and drinking history. To explore the correlation between BP and the pathogenesis of BP. Among them, 21 cases of BP were performed CT examination of the skull base of the inner ear of temporal bone with non-BP and excluding ear diseases as the control group. The multi-plane reconstruction (MPR) and curved surface reconstruction (CPR). Were performed by image reconstruction technique. The minimal diameter of the facial nerve canal (labyrinth, horizontal, vertical) of the affected side, the healthy side, the control group and the corresponding side of the affected side of BP were measured. To explore the relationship between BP pathogenesis and facial canal development. SAS data analysis kit was used to compare the incidence of BP with age. T test was used to compare the relationship between BP incidence and sex. The relationship between the incidence of BP and the minimum diameter of the facial canal by Logistics regression the hypothesis test (normality test / t test) was used to determine whether there was a gap between BP and each segment. There was significant difference in the relationship between inflammation and inflammation in each segment by using test 2 (P < 0.05). Results: 1 single factor analysis showed that cold, external ear canal herpes, hyperlipidemia and drinking history were all related to BP (P0.05). 2 Logistics regression analysis showed that cold, external ear canal herpes. Hyperlipidemia was the risk factor of BP, and the correlation was as follows: cold external ear canal herpes hyperlipidemia. The history of drinking alcohol was the protective factor of BP and had no significant pathogenicity. 3 the hypothetical test (normal test / t test) showed that the minimum diameter of the nerve tube in the affected side of BP patients was smaller than that of the normal side. In the control group, there was no significant difference in the minimum diameter of the horizontal segment in the labyrinthine segment of the facial canal, but the vertical segment was larger than that in the healthy side. 4 One-factor analysis showed that the horizontal and vertical segments of the facial nerve canal were divided into two groups. The level of peripheral inflammation was related to the incidence of BP (P0.05). 5 the recurrence rate of BP patients was 7.5 in this group. Conclusion: cold, external ear canal herpes and hyperlipidemia are the risk factors of BP, and the correlation is as follows: cold external ear canal herpes and hyperlipidemia. The minimal diameter of labyrinth segment, horizontal segment fissure, vertical segment fissure, and inflammation around horizontal segment were all related to the pathogenesis of BP. BP had no relationship with age, sex, hypertension, smoking history, drinking history and the minimum diameter of vertical segment of facial nerve canal.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R745.12

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