特发性面神经麻痹发病相关因素的临床研究

发布时间：2018-07-25 07:00

【摘要】：目的：本研究通过对特发性面神经麻痹（BP）患者的发病相关因素进行分析，，为BP的预防提供依据。方法：收集2009年1月-2013年8月吉林大学第二医院神经内科门诊及住院治疗的BP患者共160例，体检中心健康体检者160例作为对照组；对其病史、既往史、个人史、血压、头部CT或MRI、血脂、血糖、一般内科体征及神经系统体征等进行收集，以年龄、性别、高血压、高脂血症、糖尿病、受凉、外耳道疱疹、吸烟史、饮酒史这9项为对象，探讨其与BP发病的相关性。对其中21例BP者、以非BP且排除耳部疾病者为对照组，进行颞骨内耳颅底CT检查，应用图像重建技术行多平面重建(MPR)及曲面重建(CPR)。测量BP者患侧、健侧、对照组与BP者患侧的相应侧（文章中简称为对照组相应侧）面神经管各段（迷路段、水平段、垂直段）的最小管径、各段是否存在裂缺、各段周围是否存在炎症，探讨BP发病与面神经管发育的关系。统计分析采用SAS数据分析包，对BP发病与年龄的关系比较使用t检验，BP发病与性别的关系、BP发病与各发病可能相关因素的关系比较使用2检验，各发病可能相关因素之间的关系比较使用Logistics回归，BP发病与面神经管各段最小管径的关系比较使用假设检验（正态性检验、t检验），BP发病与各段是否存在裂缺、各段周围是否存在炎症的关系比较使用2检验。P＜0.05显示有统计学意义。结果： ①单因素分析显示，受凉、外耳道疱疹、高脂血症、饮酒史均与BP的发病有关（P0.05）。 ②多因素分析（Logistics回归）显示，受凉、外耳道疱疹、高脂血症均为BP发病的危险因素，相关性大小依次为：受凉外耳道疱疹高脂血症。饮酒史为BP发病的保护因素，无显著致病作用。 ③假设检验（正态性检验、t检验）显示，BP患者患侧面神经管各段最小管径均小于健侧；对照组相应侧的面神经管迷路段、水平段最小管径较患者健侧无明显差别，但垂直段较患者健侧大。 ④单因素分析显示，面神经管水平段裂缺、垂直段裂缺、水平段周围炎症与BP的发病有关（P0.05）。 ⑤本组病例中BP患者的复发率为7.5%。结论：受凉、外耳道疱疹、高脂血症均为BP发病的危险因素，相关性大小依次为：受凉外耳道疱疹高脂血症。面神经管迷路段最小管径、水平段最小管径、水平段裂缺、垂直段裂缺、水平段周围炎症均与BP的发病有关。而BP发病与年龄、性别、高血压、吸烟史、饮酒史、面神经管垂直段最小管径无关。
[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.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R745.12

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