女性良性阵发性位置性眩晕与骨密度及雌二醇关系研究

发布时间：2018-03-13 04:37

本文选题：良性阵发性位置性眩晕　切入点：骨密度　出处：《宁夏医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过对女性良性阵发性位置性眩晕患者的骨密度及雌二醇水平的测定,分析不同年龄段女性良性阵发性位置性眩晕患者的骨密度及雌二醇水平变化特点,探讨女性良性阵发性位置性眩晕可能病因。方法与资料收集2015年10月-2017年2月就诊于宁夏医科大学总医院及宁夏医科大学心脑血管病医院耳鼻咽喉头颈外科眩晕患者的基本资料,最终测定80例诊断明确的住院女性良性阵发性位置性眩晕(Benign paroxysmal positional vertigo,BPPV)患者的骨密度(bone mineral density,BMD)、T值评分(T值为骨密度与年轻健康同性别人群比较得出)以及雌二醇(通常所说的雌激素主要指雌二醇)水平,收集宁夏医科大学总医院及宁夏医科大学总医院心脑血管病医院集中健康体检女性基本资料,最终纳入52例健康对照组女性,收集其测得的骨密度、T值评分及雌二醇等相关资料。骨密度测定:利用双能X线骨密度仪(Dual-energy X-ray absorptiometry,DXA)扫描受检者腰椎。得出腰椎1,腰椎2,腰椎3,腰椎4的骨密度,骨密度以g/cm2为单位,T值为骨密度与年轻健康同性别人群比较得出。雌二醇水平测定:利用德国西门子公司ADVIA Centaur XP免疫分析仪ADVIA Centaur XP Enhanced Estradiol(e E2)竞争性免疫测定方法测得受检者雌二醇水平。雌二醇单位为pg/ml,参考范围:11.8-3000pg/ml,滤泡期(19.50-144.20),排卵期(63.90-356.70),黄体期(55.80-214.20),绝经期(0.00-32.20)。根据中华医学会妇产科学分会对女性生理周期变化特点的定义[31](绝经前期:指性女性卵巢活动时期,包括青春期至绝经期的一段时间;围绝经期:指绝经过度期到最后1次月经后1年,约45-55岁;绝经后期:绝经一直到生命终止的这段时间),对80例女性良性阵发性位置性眩晕患者进行分组:45岁分为绝经前期组,45-55岁为围绝经期组,55岁为绝经后期组。52例健康对照组女性同样分为三小组。分析80例女性良性阵发性位置性眩晕患者不同年龄段骨密度、T值及雌二醇水平变化特点,对比不同年龄段女性良性阵发性位置性眩晕患者骨密度、T值及雌二醇水平与健康体检者骨密度、T值及雌二醇水平是否存在差异。分析80例女性良性阵发性位置性眩晕患者骨密度、T值及雌二醇水平的相关性,以及52例健康体检女性骨密度、T值和雌二醇水平的相关性分析。统计方法:结果以均数±标准差(X±SD)表示,BPPV组与对照组骨密度、T值和雌二醇水平统计学差异采用独立样本T检验,相关性分析采用积差相关Pearson相关性分析。统计软件采用SPSS17.0。(P0.05)视为有统计学意义。结果80例BPPV女性,年龄34-78岁,平均年龄54.82±10.77岁,其中围绝经期和绝经后期女性比例为:75%(60/80)。健康体检对照组女性52例,年龄26-74岁,平均年龄51.78±12.45岁,其中围绝经期和绝经后期女性比例为:73%(37/52)。两组年龄独立样本t检验P=0.168,P0.05。BPPV组女性体质指数(Body mass index,BMI)为23.99±2.52,对照组BMI为23.05±2.99,两组BMI独立样本t检验P=0.052〉0.05。绝经前期BPPV组(20/80)骨密度为1.0996±0.78g/cm2,对照组(14/52)骨密度为1.2476±0.14g/cm2,P=0.030.05。BPPV组T值为0.1800±0.96,对照组为1.1000±0.89,P=0.0250.05。BPPV组雌二醇为36.53±28.65pg/ml,对照组为75.36±23.15pg/ml,P=0.0020.05。围绝经期BPPV组(27/80)骨密度为0.9802±0.89g/cm2,对照组(16/52)骨密度为1.2132±0.84g/cm2,P=0.000.05。BPPV组T值为-1.1765±0.82,对照组为.7000±1.11,P=0.000.05。BPPV组雌二醇为23.67±10.02pg/ml,对照组为31.40±6.63pg/ml,P=0.0140.05。绝经后期BPPV组(33/80)骨密度为0.9133±0.15g/cm2,对照组(22/52)骨密度为1.1879±0.14g/cm2,P=0.000.05。BPPV组T值为-1.8061±1.10,对照组为0.5273±1.03,P=0.000.05。BPPV组雌二醇为19.90±9.76pg/ml,对照组为28.56±7.26pg/ml,P=0.0010.05。80例BPPV组骨密度0.9596±0.16g/cm2,T值-1.2266±1.37,相关系数r=0.667,P=0.000.05;52例对照组骨密度1.2117±0.13g/cm2,T值0.7558±1.10,相关系数r=0.435,P=0.0010.05。80例BPPV组骨密度0.9596±0.16g/cm2,雌二醇22.8522±13.53pg/ml,相关系数r=0.337,P=0.0080.05;52例对照组骨密度1.2117±0.13g/cm2,雌二醇42.1494±24.12,相关系数r=0.279,P=0.0450.05。80例BPPV组T值-1.2266±1.37,雌二醇22.8522±13.53pg/ml,相关系数r=0.328,P=0.0100.05;52例对照组T值0.7558±1.10,雌二醇42.1494±24.12pg/ml,相关系数r=0.270,P=0.0530.05。结论1.绝经前期、围绝经期、绝经期女性良性阵发性位置性眩晕与骨密度下降有关。2.绝经前期、围绝经期、绝经期女性良性阵发性位置性眩晕与雌二醇水平下降有关。
[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.

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R580;R764

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