摘要：

目的 探讨女性绝经后血清性激素和 25-羟胆钙化醇［25-(OH)-D₃］表达变化与良性阵发性位置性眩晕（BPPV）之间的关系。方法 选择 2015 年 9 月 1 日至 2017 年 2 月 1 日共 63 例 50 ~ 80 岁绝经后女性良性阵发性位置性眩晕患者，采用电化学发光法检测血清雌二醇、黄体酮、黄体生成素、促卵泡激素和25-(OH)-D₃水平，采用Spearman秩相关分析年龄与雌二醇、雌二醇与25-(OH)-D₃之间的关联性；采用单因素和多因素逐步法 Logistic 回归分析筛查疾病危险因素。结果 BPPV 组患者血清雌二醇［15.67（10.96，22.15）pg/ml］和 25-(OH)-D₃［（24.24 ± 1.05）ng/ml］水平均低于对照组［雌二醇：31.78（25.60，39.50）pg/ml，25-(OH)-D₃：（27.62 ± 0.76）ng/ml］，且组间差异具有统计学意义（Z = -6.768，P = 0.000；t = -2.605，P = 0.010），而黄体酮、黄体生成素、促卵泡激素组间差异无统计学意义。相关分析显示，两组受试者血清雌二醇与 25-(OH)-D₃ 水平无关联性；但对照组年龄与血清雌二醇水平呈负相关（r_s = -0.263，P = 0.038），BPPV 组二者则无关联性。多因素逐步法 Logistic 回归分析显示，绝经后女性血清雌二醇和 25-(OH)-D₃水平降低是良性阵发性位置性眩晕的危险因素。结论 血清雌二醇和 25-(OH)-D₃水平降低可能是女性绝经后罹患良性阵发性位置性眩晕的危险因素。

关键词: 眩晕, 耳石膜, 骨化二醇, 性腺甾类激素, 回归分析

Abstract:

Objective To explore the change of serum sex hormones and 25-hydroxycholecalciferol [25-(OH)-D₃ ] level in postmenopausal female patients with benign paroxysmal positional vertigo (BPPV). Methods Electrochemiluminescence (ECL) assay was employed to detect the serum levels of estradiol (E₂), progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and 25-(OH)-D₃ in 63 female postmenopausal BPPV patients with age 50-80 years from September 1, 2015 to February 1, 2017. Spearman rank correlation analysis was used to analyze the relation between age and E₂ , E₂ and 25-(OH)-D₃. Univariate and multivariate stepwise Logistic regression analysis were used to screen the risk factors for BPPV. Results The serum levels of E₂ [15.67 (10.96, 22.15) pg/ml] and 25-(OH)-D₃ [(24.24 ± 1.05) ng/ml] in BPPV group were lower than those in control group [E₂: 31.78 (25.60, 39.50) pg/ml, 25-(OH)-D₃: (27.62 ± 0.76) ng/ml], and the differences were statistically significant (Z = -6.768, P = 0.000; t = -2.605, P = 0.010). There was no significant difference on progesterone,  LH and FSH between 2 groups. Correlation analysis showed there was no relation between E₂ and 25-(OH)-D₃ levels in both groups. There was a negative correlation between age and E₂ in control group (r_s = -0.263, P = 0.038), but no correlation in BPPV group. Multivariate Logistic regression analysis showed decreased serum E₂ and 25-(OH)-D₃ levels maybe the risk factors for postmenopausal female BPPV patients. Conclusions E₂ and 25-(OH)-D₃ deficiency are independent risk factors for BPPV in postmenopausal female patients.

Key words: Vertigo, Otolithic membrane, Calcifediol, Gonadal steroid hormones, Regression analysis