摘要
目的总结分析不同类型双侧突发性耳聋(bilateral sudden sensorineural hearing loss,BSSHL)的临床特征,为临床诊治提供依据。方法连续收集2008-2019年于解放军总医院耳内科行住院治疗的124例BSSHL患者的临床表现、纯音测听、影像学检查及凝血功能等数据,对两种不同类型BSSHL,即双耳相继突聋(sequential BSSHL,se-BSSHL)和双耳同时突聋(simultaneous BSSHL,si-BSSHL)的临床特征进行分析比较,采用二元Logistic回归分析多因素对预后的作用。结果本研究124例BSSHL患者中se-BSSHL46例(男23例,女23例),平均年龄为49.28±15.98岁,伴有耳鸣者78.3%(36/46)、耳闷30.4%(14/46)、眩晕45.7%(21/46);si-BSSHL78例(男50例,女28例),平均年龄为47.71±19.27岁,伴有耳鸣者87.2%(68/78)、耳闷43.6%(34/78)、眩晕42.3%(33/78),不同类型BSSHL间性别组成、年龄分布及是否伴有耳鸣、耳闷、眩晕症状差异无明显统计学意义;se-BSSHL第2耳治疗有效率为34.8%,有效组中平均病程较短;si-BSSHL有效率为29.5%,其疗效与活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)相关(Logistic,P<0.05);未发现年龄、性别、听力损失严重程度、听力损失分型、伴随症状及合并疾病等对BSSHL的疗效产生显著影响。结论se-BSSHL较si-BBSHL听力改善情况好,早期系统治疗是se-BSSHL预后的有利因素;凝血功能可能与si-BSSHL患者疗效密切相关。
Objective To report clinical characteristics of bilateral sudden sensorineural hearing loss(BSSHL)for improvement of diagnosis and treatment.Methods Clinical manifestations,pure tone audiometry,imaging and coagulation function test results from 124 patients with BSSHL admitted to the Department of Otology,PLA General Hospital from 2008 to 2019 were reviewed.Clinical features were compared between simultaneous BSSHL(si-BSSNHL)and sequential BSSHL(se-BSSNHL),and binary logistic regression was used to examine influence of multiple factors on prognosis.Results Of the 124 patients,46 had se-BSSHL(23 males and 23 females)with an average age of 49.28±15.98 years.Among the 46 patients with se-BSSNHL,36(78.3%)also reported tinnitus,14(30.4%)experienced ear fullness and 21(45.7%)had vertigo.The rest 78 patients had si-BSSHL(50 males and 28 females)and an average age of 47.71±19.27 years.Tinnitus was reported by 68 of these patients(87.2%),ear fullness by 34(43.6%)and vertigo by 33(42.3%).There was no significant difference in gender composition,age distribution and concurrent symptoms between the two groups.Treatment effective rate was 34.8%for later affected ears with relatively short disease courses in patients with se-BSSHL,whereas the rate was 29.5%in patients with si-BSSHL,in whom logistic regression analysis showed that activated partial thromboplastin time(APTT)was correlated with treatment efficacy(P<0.05),while other variables(age,sex,severity of hearing loss,SSHL classification,concurrent symptoms and diseases)were not.Conclusion Treatment efficacy appears to be better in se-BSSHL than in si-BSSHL,especially if initiated early.Coagulation function is closely related to treatment efficacy in patients with si-BSSHL and may be a key pathogenic factor.
作者
王浩然
王大勇
冰丹
尹自芳
赵立东
谌国会
于澜
王洪阳
关静
王秋菊
WANG Haoran;WANG Dayong;BING Dan;Yin Zifang;ZHAO Lidong;CHEN Guohui;YU Lan;WANG Hongyang;GUAN Jing;WANG Qiuju(College of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Beijing,China.National Clinical Research Center for Otolaryngologic Diseases,Beijing,China.Chinese PLA Institute of Otolaryngology.Key Lab of Hearing Science,Ministry of Education,China.Key Lab of Hearing Impairment for Prevention and Treatment of Beijing,Beijing 100853,China.)
出处
《中华耳科学杂志》
CSCD
北大核心
2020年第2期249-255,共7页
Chinese Journal of Otology
基金
国家自然科学基金重点项目(81830028,81530032)
国家自然科学基金青年项目(81900951,81900950)
军队医学科技青年培育计划孵化项目(19QNP058)
军队后勤科研计生专项(19JSZ14)
北京市自然科学基金青年项目(7204312)联合资助。
关键词
双侧突发性耳聋
临床特征
疗效
住院患者
Bilateral Sudden Sensorineural Hearing Loss
Clinical Characteristics
Efficacy
Inpatient
