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目的:分析不同海拔地区神经内科门诊头晕患者病因构成特点。方法:回顾性分析青海大学附属医院(海拔2 200m地区)及青海海南藏族自治州人民医院(海拔3 000m地区)2012年1月—2013年12月神经内科门诊就诊分别212例和205例头晕为主症世居当地患者完整登记资料及随访资料,分析临床特点、辅助检查、治疗转归,总结及比较病因构成。结果:海拔2 200m地区和3 000m地区神经内科门诊头晕患者男女比例分别为11.49和11.36,以(40~59)岁年龄段中老年最多见,分别为88例(41.51%)和96例(46.83%)。海拔2 200m地区常见头晕前三位病因依次为精神障碍性88例(41.51%),前庭周围性65例(30.66%),其中良性发作性位置性眩晕为42例,平衡障碍性36例(16.98%);海拔3 000m地区常见头晕前三位病因依次为系统疾病相关性77例(37.56%),前庭周围性70例(34.15%),其中良性发作性位置性眩晕为47例,精神障碍性32例(15.61%)。结论:高原地区神经内科门诊头晕患者以中老年女性多见,不同海拔地区常见头晕病因有所不同,相同的是精神障碍性和良性发作性位置性眩晕多见,对头晕为主症的门诊患者焦虑、抑郁评分及Dix-Hallpike试验不容忽视,以上结果为今后门诊头晕患者诊治提供参考。
Objective: To analyze the causes of dizziness in neurology outpatients at different altitudes. Methods: A retrospective analysis of Qinghai University Hospital (elevation 2 200m area) and Qinghai Tibetan People’s Hospital of Hainan Autonomous Prefecture (elevation 3000m area) January 2012 - December 2013 neurology outpatient treatment of 212 cases and 205 cases of dizziness-based Symptoms of the local patients with complete registration information and follow-up information, analysis of clinical features, laboratory examinations, treatment, summary and comparison of the cause of formation. Results: The ratio of male to female dizziness in neurosurgery outpatients at 2 200 m altitude and 3 000 m altitude was 1 1.49 and 1 1 36, respectively. The prevalence rate was 40 cases in middle age (40 to 59 years), 88 cases (41.51%) and 96 cases (46.83%). The top three causes of common dizziness at an altitude of 200m were 88 cases (41.51%) of psychosis, 65 cases (30.66%) of vestibular circumferences, 42 cases of benign paroxysmal positional vertigo and 36 cases of balance disorders (16.98% %). The first three causes of common dizziness at 3000m altitude were systemic disease-related 77 cases (37.56%), vestibular peripheral 70 cases (34.15%), benign paroxysmal positional vertigo 47 cases, mental disorder 32 cases (15.61%). Conclusions: Dizziness patients in neurology outpatient departments in the plateau are more common in middle-aged and elderly women. The causes of common dizziness are different in different altitude areas. The same is that mental disorders and benign episodes of positional vertigo are more common, Anxiety, depression scores and Dix-Hallpike test can not be ignored, the above results provide reference for the diagnosis and treatment of patients with dizziness in the future.