维生素D缺乏在耳石症发病机制中的作用

The Role of Vitamin D Deficiency in the Pathogenesis of Benign Paroxysmal Positional Vertigo

摘要: 耳石症，又名良性阵发性位置性眩晕(Benign paroxysmal positional vertigo, BPPV)，是一种常见的周围性前庭疾病，近年研究显示维生素D (Vitamin D, VitD)缺乏或许和BPPV的发病以及复发存在关联，其具体机制和临床适用性还需更细致地深入探讨。本文系统综述了VitD通过调控耳石矿化、内耳钙稳态以及耳石膜稳定性来影响BPPV的潜在机制，并且基于最新临床证据分析了VitD补充的效果和存在的局限性，现有证据表明VitD补充可能对血清VitD水平显著低下的复发性BPPV患者更具有临床价值，然而其对不同BPPV亚型像后半规管型与水平半规管型的疗效仍需进一步加以区分，此外不同剂量VitD的干预效果以及长期安全性仍需要更多高质量研究给予支持。

Abstract: Otolithiasis, also known as benign paroxysmal positional vertigo (BPPV), is a common peripheral vestibular disorder. Recent studies have suggested that a deficiency in Vitamin D (VitD) may be associated with the onset and recurrence of BPPV. However, the specific mechanisms and clinical applicability of this association require further detailed investigation. This article systematically reviews the potential mechanisms by which Vitamin D (VitD) influences BPPV through the regulation of otolith mineralization, calcium homeostasis in the inner ear, and the stability of the otolith membrane. It also analyzes the effects and limitations of VitD supplementation based on the latest clinical evidence. Current evidence suggests that VitD supplementation may be more clinically valuable for recurrent BPPV patients with significantly low serum VitD levels. However, its efficacy for different BPPV subtypes, such as posterior canal and horizontal canal types, still needs further differentiation. Additionally, the intervention effects of different doses of VitD and its long-term safety require more high-quality studies for support.