摘要
目的：对突发性聋中全聋型及平坦型进行进一步分类,明确和听力预后的关系。方法：对192例突聋患者进行分析,尤其对159例平坦型以及全聋患者进行进一步曲线类型分型,分为上升型,下降型以及一致型,对听力恢复相关的因素进行多因素采用有序回归分析。结果：显示年龄按照45岁分组,差别无统计学意义（P〉0.05）;病程按照0~7d和14d以上者比较,P〈0.01,OR=4.291;8~14d和14d以上比较,P〈0.05,OR=2.983;按照平坦型以及全聋分组,P〈0.05,OR=0.409;按照平坦聋和全聋曲线类型,上升型和和全聋型相比,P〈0.05,OR=9.692;下降型,一致型和全聋型相比,差异无统计学意义（均P〉0.05）。从OR值可以看出,和听力预后最相关的为曲线类型。结论：按照发病机制分类,将突发性聋分为上升型,下降型,一致型,更能体现突发性聋的发病机制及预后。上升型,包括指南中提出的低频型突发性聋以及本文中两类上升型突发性聋,这类突发性聋可能的发病机制为不同程度积水或者血管纹病变为主,预后较好;下降型,则包括指南中提出的高频型突发性聋以及本文中2类下降型突发性聋,这类突发性聋以毛细胞损伤为主,预后较差。一致型则包括本文提出的轻度（平坦一致型）及重度（全聋）,可能和血管纹以及潜在的迷路炎有关,预后较差。
Objective：Reclassified the total deafness and flat type of sudden deafness,identified the relationship between new classification and hearing prognosis.Method：To analyze 192 cases of patients with sudden deafness,especially for 159 cases of flat type and total deafness patients for further curve type classification,classified as rise,decline and consistent,analysis the possible factors with hearing in multiple factors using regression analysis.Result：According to age group of 45 years old,P〈0.05,the difference has not statistically significant;Course of the disease according to the 0-7days and 14 days more,P〈0.01,OR=4.291;8-14 days and 14 days,P〈0.05,OR=2.983;According to the flat type and total deafness grouping,P〈0.05,OR=0.409;According to the curve type of deafness,the difference between rise type and total deafness was significant,P〈0.01,OR=9.692;Decline type,consistent type compared to total deafness type,there is no statistically significant difference,P〈0.05.Conclusion：According to the pathogenesis of classification,sudden deafness can be divided into rise type,decline type and consistent type.The pathogenesis of rise type may be different degree of hydrops of inner ear.Decline type may be hair cell damage,and consistent type may be related to the damage of vascular stria and potential labyrinthitis,prognosis is poorer.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2016年第14期1127-1130,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
北京大学人民医院研究与发展基金(No:RDC2015-29)
关键词
突发性聋
突聋分类
发病机制
sudden deafness
sudden deafness classification
pathogenesis
