Study On The Prediction Value Of Nystagmus Characteristics For Manual Reduction Of Posterior Semicircular Canal BPPV

Objective Benign paroxysmal positional vertigo(BPPV)patients’nystagmus characteristics(including latency,duration,intensity)and prognosis were collected,and the correlation between them was statistically analyzed.It provides a new basis for prognosis prediction and targeted treatment of posterior semicircular canal BPPV patients.Methods A total of 281patients with posterior semicircular canal BPPV in out-patient and ward of Vertigo Center of Baotou Central Hospital from January 2021 to June 2021 were selected as the research objects,meeting the diagnostic criteria,inclusion criteria and exclusion criteria.The study doctors introduced the study orally,obtained the informed consent of patients and their families,and collected the nystagmus characteristics of all patients.All patients in the group were given otolith reduction therapy(Epley method),such as dizziness,balance disorders and other symptoms after reduction,plus medication(medicine to improve inner ear microcirculation,such as betahistine,ginkgo biloba,etc.),according to patient treatment The effect makes the dizziness or nystagmus disappear in the end.Record the number of resets and the length of the disease.All patients were evaluated on 1 month,3 months,and 6 months.According to recurrence,they are divided into recurrence group and non-recurrence group.Univariate and multivariate Cox regression models were used to analyze the influencing factors of BPPV recurrence.The optimum cut-off value of nystagmus parameters for predicting BPPV recurrence was calculated by receiver operating characteristic(ROC)curve,and the optimal cut-off value was used as the boundary for grouping.Kaplan-meier method was used to plot the recurrence-free survival curve.Results Univariate Cox regression showed that age,hypertension,coronary heart disease,diabetes,hyperlipidemia,intensity H,intensity V were significantly correlated with relapse(P<0.05).Multivariate Cox regression analysis showed that age,hypertension,intensity H and intensity V were independent influencing factors of relapse(P<0.05).The ROC curve showed that the area under the strength H index curve was0.78,95%confidence interval(0.72-0.84),the optimal cut-off value was 22.5,the sensitivity was 67.76%,and the specificity was 73.13%.The area under the curve of intensity V index was 0.80,95%confidence interval(0.75-0.86),the optimal truncation value was 21.50,sensitivity was 74.77%,specificity was 74.63%.Survival analysis showed that the recurrence free survival time of nystagmus intensity H≥22.5 and intensity V≥21.5 groups was significantly higher than that of nystagmus intensity H<22.5 and intensity V<21.5 groups.Conclusion 1.Nystagmus intensity can be used as a predictor of recurrence of POSTERIOR semicircular canal BPPV.2.Age,hypertension,intensity H and intensity V had significant influence on the recurrence rate of patients,that is,old age,hypertension and weak nystagmus intensity all increased the risk of recurrence.