目的: 分析总结单侧全聋型突聋患者的临床特征以及实验室检查结果,探讨影响患者听力恢复的因素。方法: 搜集2019年9月―2022年10月在湖南师范大学附属长沙市第四医院住院的单侧全聋型突聋患者的临床及实验室检查资料（共89例）,分析患者性别、年龄、患耳、发病至就诊时间、有无伴随症状（耳鸣、头晕、耳闷）、有无伴发疾病（高血压、糖尿病、心脏病、高脂血症）、以及血液学参数（中性粒细胞数、淋巴细胞数、纤维蛋白原、白蛋白、血脂）对预后的影响。结果: 单因素分析显示发病至就诊时间、性别、患耳、耳鸣、耳闷、高血压、糖尿病、心脏病、高脂血症与单侧全聋型突聋患者疗效无关;年龄≥40岁患者有效率为33.90%明显低于年龄<40岁的86.96%。伴眩晕者有效率为25%,低于不伴眩晕者的63.4%;单侧全聋型突聋患者中性粒细胞数、淋巴细胞数、血小板数、纤维蛋白原、白蛋白、甘油三酯、低密度脂蛋白、FAR、PLR、NLR与预后影响无明显相关性;而血总胆固醇、高密度脂蛋白有明显相关性;对年龄、眩晕、总胆固醇、高密度脂蛋白进行多因素Logistic 回归分析,发现年龄与单侧全聋型突聋患者预后无明显相关性,而眩晕、总胆固醇、高密度脂蛋白均显著相关。结论: 眩晕、总胆固醇、高密度脂蛋白是影响单侧全聋型突聋患者听力恢复的重要危险因素。
Abstract
Objective To investigate the clinical characteristics and laboratory test results (such as hematological parameters) of patients with sudden unilateral total sensorineural hearing loss and to explore the factors affecting the curative effect of hearing recovery. Methods The clinical and laboratory examination data of 89 patients with sudden unilateral total sensorineural hearing loss hospitalized in Changsha Fourth Hospital Affiliated to Hunan Normal University from September 2019 to October 2022 were collected, and the gender, age, affected ears, time from onset to medical treatment, accompanied symptoms (tinnitus, dizziness, ear tightness), accompanied diseases (hypertension, diabetes, heart disease, hyperlipidemia) and the influence of hematological parameters (neutrophil number, lymphocyte number, fibrinogen, albumin, blood lipid) on prognosis. Results Univariate analysis showed that the time from onset to treatment, gender, affected ear, tinnitus, ear fullness, hypertension, diabetes, heart disease and hyperlipidemia were not related to the efficacy of patients with unilateral total sudden deafness. The effective rate of patients over 40 years old was 33.90%, which was significantly lower than 86.96% of patients under 40 years old. The effective rate of patients with vertigo was 25%, which was lower than 63.4% of patients without vertigo. Neutrophil count, lymphocyte count, platelet count, fibrinogen, albumin, triglyceride, low-density lipoprotein, FAR, PLR, NLR were not related to the prognosis of patients with unilateral total sudden deafness. There was a significant correlation between total cholesterol and high-density lipoprotein. Multivariate Logistic regression analysis of age, vertigo, total cholesterol and high-density lipoprotein showed that age was not related to the prognosis of patients with unilateral sudden deafness, while vertigo, total cholesterol and high-density lipoprotein were significantly related. Conclusion vertigo, total cholesterol and high-density lipoprotein are important risk factors for auditory recovery in patients with sudden unilateral total deafness.
关键词
突发性耳聋 /
全聋型 /
血液学参数 /
临床症状 /
预后
Key words
sudden hearing loss /
total deafness /
hematological parameters /
clinical symptoms /
prognosis
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