血浆乳酸在突发性耳聋发病和预后中的临床意义。

Rejuvenation research Pub Date : 2024-06-01 Epub Date: 2024-04-09 DOI:10.1089/rej.2023.0071
Ling Wang
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引用次数: 0

摘要

突发性耳聋对患者的生活质量构成重大威胁,但评估其发病和预后的有效指标却仍然难以确定。内耳主要由缺乏侧支循环的迷走神经动脉供血。凝血功能和血液流变学的变化可引起迷走神经动脉痉挛或血栓形成,导致内耳缺血、缺氧和微循环障碍,最终导致突发性耳聋。这项回顾性研究采用《2015 年中国突发性耳聋诊断与治疗分类指南》,对 196 名突发性耳聋患者进行了检查。凝血系统分析采用 STA-R Evolution 自动凝血分析仪,测量活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和纤维蛋白原(FIB)。使用强生 Fusion 5.1 型血浆乳酸检测仪测定血浆乳酸浓度。研究结果显示,听力损失程度与疾病预后之间存在相关性。与听力损失程度较轻的患者相比,听力损失程度较高的患者入院时血浆乳酸水平较高。重要的是,入院时血浆乳酸水平升高是治疗结果的预测指标。此外,治疗无效的患者表现出更易凝血的状态,入院时较低的 APTT(治疗无效:31.47±4.55 秒,治疗有效:35.17±5.38 秒)和 PT 以及较高的血浆 FIB 都证明了这一点。总之,入院时的血浆乳酸水平有望成为突发性耳聋治疗效果的预后指标,为临床管理提供有价值的见解。
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Clinical Relevance of Plasma Lactic Acid in the Onset and Prognosis of Sudden Deafness.

Sudden deafness poses a significant threat to patients' quality of life, yet effective indicators for evaluating its onset and prognosis remain elusive. The inner ear is primarily supplied by the labyrinthine artery, which lacks collateral circulation. Changes in coagulation function and hemorheology can cause spasm or thrombosis of the labyrinthine artery, leading to ischemia, hypoxia, and microcirculation disorders in the inner ear, ultimately resulting in sudden deafness. This retrospective study examined 196 patients with sudden deafness, utilizing the 2015 Chinese guideline for diagnosis and treatment classification. Coagulation system analysis used the STA-R Evolution automatic coagulation analyzer, measuring activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB). Plasma lactate concentration was determined using a Johnson and Johnson Fusion 5.1 model plasma lactate detector. Results of the study revealed a correlation between the degree of hearing loss and disease prognosis. Patients with higher grade hearing loss exhibited elevated plasma lactate levels upon admission compared with those with lower grade hearing loss. Importantly, elevated plasma lactate levels at admission served as predictive indicators for treatment outcomes. In addition, patients with ineffective treatment demonstrated a more coagulable blood state, as evidenced by the lower APTT (ineffective treatment: 31.47 ± 4.55 seconds, effective treatment: 35.17 ± 5.38 seconds) and PT on admission, but higher plasma FIB. In conclusion, plasma lactate levels upon admission hold promise as prognostic markers for sudden deafness treatment outcomes, providing valuable insights for clinical management.

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