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目的 比较飞行人员和普通人员眩晕的病因构成特点,为前庭疾病的精准诊治及飞行人员航空医学鉴定提供依据. 方法 纳入 2017 年 1 月至 2018 年4 月于原空军总医院眩晕中心门诊诊治的 1 016 名普通眩晕患者为普通人员组;1984 年 9 月至 2018 年 8 月期间在原空军总医院住院诊治和鉴定的 153 名眩晕飞行人员作为飞行人员组.对普通人员组进行性别、年龄的病因分层分析,对飞行人员组进行疾病谱变化分析,并比较两组人群的病因构成特点. 结果 ①1 016 例普通人员组共计 1 265 例次病因(部分病人合并两种以上病因)中,前 7 位病因分别为良性阵发性位置性眩晕(Benign paroxysmal positional vertigo,BPPV)32.73% (414/1 265 )、前庭性偏头痛(Vestibular migraine,VM)31.46%(398/1 265)、高血压病 12.96%(164/1 265)、糖尿病 4.03%(51/1 265)、梅尼埃病(Meniere,s disease,MD)3.87%(49/1 265)、前庭神经元炎(Vestibular neuronitis,VN)3.87% (49/1 265)、脑梗塞 3.24%(41/1 265).不能分类的眩晕 1.34%(17/1 265).②普通人员组按年龄进行病因分层:纳入患者年龄为 8~89 岁.60 岁组前 4 位病因依次为 BPPV (31.28%)、VM(20.59%)、高血压(20.05%)、脑梗塞(6.68%).前 7 位病因中,除 VN 和 MD外,其他病因在不同年龄组的检出率差异均有统计学意义(χ2=13.45~53.16,P<0.01).③普通人员组按性别进行病因分层:男女比例 1.00︰1.57.VM在女性中的检出率高于男性,差异有统计学意义(χ2=28.84,P<0.05);高血压、MD及VN在男性患者中的检出率高于女性,差异均具有统计学意义(χ2=3.87~8.93,P<0.05).其他病因在性别分层上差异无统计学意义.④153 例飞行人员共计 184 例次病因中(部分人员合并两种以上病因),前 3 位明确诊断的病因分别为晕动病(motion sickness, MS)11.41%(21/184)、VN 10.32%(19/184)、MD 9.78%(18/184).不能分类的眩晕达 57.61%(106/184).⑤飞行人员组BPPV及 VM检出率低于普通人员组(χ2=78.34、78.77,P<0.01 );但不能分类的眩晕、MS 、MD、VN及变压性眩晕检出率高于普通人员组(χ2=6.02~645.59,P<0.05). 结论 头晕(眩晕)患者病因复杂、多样,同一患者可能有两种以上病因,对患者进行病因分层分析,有利于前庭系统疾病的精准诊疗.对飞行人员与普通人员进行病因比较分析,有利于探讨在飞行环境中眩晕的发病机制及防治措施,为航空医学鉴定提供依据.“,”Objective To compare the etiology of vertigo patients between flying personnel group and ordinary group and to provide evidence for the accurate diagnosis of vertigo or dizziness and the aeromedical assessment. Methods One thousand and sixteen ordinary vertigo patients,who were diagnosed by the Vertigo Center of Former Air Force General Hospital of PLA in the period from January 2017 to April 2018,were assigned to ordinary group.One hundred and fifty-three vertigo inpatients and outpatients of flying personnel,who were diagnosed by the hospital in the period from September 1984 to Augut 2018,were selected as flying personnel group.The etiological stratification analysis was conducted upon the gender and age in ordinary group.The disease spectrum was analyzed in flying personnel group.The etiological characteristics were compared between two groups. Results①In ordinary group,1 265 etiological factors were found in 1 016 vertigo patients (some of them had 2 or more etiologies).The top 7 etiological factors of the vertigo patients in ordinary group were benign paroxysmal positional vertigo (BPPV)that took 32.73 % (414/1 2 6 5 ),vestibular migraine (VM),31.46% (398/1 265 ),hypertension 12.96% (164/1 265 ),diabetes 4.03% (51/1 265 ), Meniere,s disease(MD)3.87%(49/1 265),vestibular neuritis(VN)3.87%(49/1 265),and cerebral infarction 3.24%(41/1 265).1.43%(1 7/1 265)cases were unable to categorize clearly.②The patients of ordinary group,aged from 8 to 89 yrs,were categorized to 60 yrs subgroups.The top 4 etiological factors for 60 yrs group were BPPV (3 1 .28%),VM (20.5 9%),hypertension (20.05%),and cerebral infraction (6.68%). Detection rate of the top 7 etiological factors had significant difference in different age groups except VN and MD (χ2=1 3 .45-5 3 .1 6 ,P<0.0 1 ).③The etiological stratification by gender showed that the ratio of male to female was 1.00︰1.57.Detection rate of VM in female was higher than that in male. Detection rate of hypertension,MD and VN in male was higher than that in female,the difference was satistically significant (χ2=3.87-8.93,P<0.05).④In flying personnel group,184 etiological factors were found in 153 vertigo patients (some of them had 2 or more etiologies).Top 3 etiological factors were motion sickness(MS)that took 1 1 .41%(21/184),VN that took 10.32%(1 9/184)and MD that took 9.78% (18/184 ).The dizziness or vertigo with no accurate etiology took 57.61 % (106/184 ).⑤The BPPV and VM detection rate in flying personnel group were less than those in ordinary group (χ2=78.34,78.7 7 ,P<0.0 1 ).The dizziness or vertigo cases with no accurate etiology and MS,MD, VN and alternobaric vertigo cetection rate in flying personnel group were higher than those in ordinary group (χ2=6 .02-645 .5 9 ,P<0.05 ). Conclusions The causes of vertigo/dizziness are complex and diverse and patients may have more than one etiology.The etiological stratification analysis for patients is conducive to accurate diagnosis and treatment.Studying the difference of etiology between flying personnel and ordinary people will contribute to exploring the pathogenesis and prevention measures in flight environment and providing proof for aeromedical assessment.