| Objective:By analyzing the risk factors of central ischemic vertigo,this study aims to modify the ABCD~2scoring scale based on the independent risk factors,and analyze its value in the etiological diagnosis of patients with isolated vertigo,so as to improve the diagnostic value of ABCD~2scoring scale in the diagnosis of isolated central ischemic vertigo.To provide a reference for the rapid diagnosis of central ischemic isolated vertigo.Methods:Data of patients with isolated vertigo as chief complaint were collected from the Department of Neurology of the First People’s Hospital of Xiangtan City from January 2018 to December 2019.According to the inclusion and exclusion criteria,333patients were enrolled.According to the diagnostic criteria of the disease,the patients were divided into central ischemic vertigo group(central ischemia group)and non-central ischemic vertigo group.In the analysis of risk factors,t test or non-parametric rank sum test was used for the comparison between quantitative data groups,and chi-square test was used for the comparison of qualitative data.The variables with statistical significance in univariate analysis were included in multivariate Logistic regression analysis.The independent risk factors in the central ischemia group were combined with the ABCD~2scoring scale to form a modified ABCD~2scoring scale.The ROC curve was used to evaluate the value of different scoring scales in the etiological diagnosis of patients with isolated vertigo.Med Calc software was used to compare the difference of area under the curve of each scoring scale.Results:1.Comparison of age between central ischemic patients and non-central ischemic patients with isolated vertigo:in the central ischemic group and non-central ischemic group,22 cases(23.66%)and 97 cases(40.42%)were<60 years old,and 71 cases(76.34%)and 143 cases(59.58%)were≥60 years old,respectively.The age distribution of patients in the two groups was statistically analyzed,χ~2=8.199 after the chi-square test,P=0.004,the difference was statistically significant.2.In the central ischemia group,there were 55 males(59.14%)and 38 females(40.86%);There were 79 males and 161 females in the non-central ischemia group.The age distribution of the two groups was statistically analyzed,χ~2=19.169 after the chi-square test,P<0.001,the difference was statistically significant.3.The systolic blood pressure≥140mm Hg and/or diastolic blood pressure≥90mm Hg were measured in 45 cases(48.39%)and 87 cases(36.25%)of patients in the central ischemia group and the non-central ischemia group at admission,respectively.There was statistical significance in the difference between the two groups of patients with abnormal blood pressure(P<0.05).4.The duration of vertigo symptoms<10min was 38(40.86%)in the central ischemia group and 186(77.50%)in the non-central ischemia group,respectively.There were 19 cases(20.43%)in central ischemia group and 29 cases(12.08%)in non-central ischemia group after 10min to 1h.Patients with>for 1h or with persistent symptoms were 36(38.71%)in the central ischemia group and 25(10.42%)in the non-central ischemia group.The difference in symptom duration between 2 groups was statistically significant(P<0.05).5.Previous hypertension,coronary heart disease,diabetes,cerebrovascular disease,atrial fibrillation history,smoking,drinking history and high HCY level were risk factors in the central ischemia group.After adjusting for gender and age,the correlation between previous hypertension,coronary heart disease,atrial fibrillation history and the central ischemia group was still statistically significant(P<0.05).Logistic regression analysis showed that male sex,history of hypertension,history of atrial fibrillation and high HCY level were independent risk factors affecting the incidence of central ischemic isolated vertigo.6.From the above result,male gender,and always merge history of hypertension,atrial fibrillation for central independent risk factors of ischemic vertigo isolation and replacing it with usual presence of hypertension ABCD~2"B"in the rating scale,amend the ABCD~2score scale to AB’CD~2rating scale,including hypertension,1 minute,0 no hypertension patients;1 point was recorded for male and 0 point for female.ABCD~2and AB’CD~2scoring scales were modified into ABCD~2E and AB’CD~2E scoring scales respectively.Considering the small sample size of patients with atrial fibrillation,only 6cases(6.5%)in the central ischemia group and only 1 case(0.40%)in the non-central ischemia group,they were not included in the scoring scale.7.The areas under the ROC curve corresponding to ABCD~2,AB’CD~2,ABCD~2E and AB’CD~2E scoring scales were 0.701,0.736,0.762 and 0.769,respectively,which were statistically significant different from the baseline.8.The area under the curve of the four scoring scales was compared in pairs,and there was no statistical significance in the area under the curve between ABCD~2scoring scale and AB’CD~2scoring scale,between AB’CD~2scoring scale and ABCD~2E scoring scale,or between AB’CD~2E scoring scale and ABCD~2E scoring scale.There were significant differences in area under the curve between ABCD~2scoring scale and AB’CD~2E scoring scale,between ABCD~2scoring scale and AB’CD~2E scoring scale,and between AB’CD~2scoring scale and AB’CD~2E scoring scale(P<0.05).9.The diagnostic threshold of ABCD~2,ABCD~2E,AB’CD~2,AB’CD~2E for central ischemic isolated vertigo was>1,>2,>2,and>2,respectively.The corresponding sensitivity/specificity were 0.59/0.76,0.70/0.72,0.58/0.79 and 0.76/0.65,respectively.Conclusion:1.Gender(male),hypertension,and history of atrial fibrillation are independent risk factors for the onset of central ischemic isolated vertigo.2.The combination of ABCD~2scoring scale and gender can improve the accuracy of the diagnosis of central ischemic isolated vertigo. |
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