[169例双侧突发性感音神经性听力损失患者的临床特征和疗效分析]。

X H Zhao, X N Wu, H R Wang, D Bing, D Y Wang, Q J Wang
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引用次数: 0

摘要

目的分析双侧突发性感音神经性听力损失(BSSHL)的临床特征、疗效相关因素及随访情况。方法回顾性总结 169 例 BSSHL 患者(338 耳)的临床资料,统计描述其人口统计学特征、致病因素、伴随症状和疾病以及听力学特征。此外,还对疗效和预后的影响因素进行了统计分析。结果在 169 例患者中,50.9%(86/169)的患者至少有一种诱因,其中感冒和疲劳是最常见的诱因(均为 23/169)。伴随症状的发生率很高,包括耳鸣(150/169,88.8%)和头晕(100/169,59.2%)。高血压(49/169,29.0%)和糖尿病(23/169,13.6%)是最常见的并发症。大多数病例表现为全频受累,其中平耳型和全聋型占 83.1%(281/338 耳)。最常见的听力损失程度是全聋(86/338 耳),约 60.1%(203/338 耳)的病例为重度或更严重。治疗总有效率仅为 29.0%,但病程≤14 天的患者治疗总有效率上升至 39.5%,但当病程>30 天时,治疗总有效率急剧下降至 3.6%,两组间差异有显著性(χ2=13.776,χ2=14.782,PZ 值分别为-2.495, -3.083, -3.970, -3.388 和 -3.264,均为 PConclusion):BSSHL 患者听力损失严重,许多患者还伴有耳鸣和眩晕症状。由于治疗效果不佳,患者最好在发病 30 天内接受治疗。对于低频范围的听力损失患者来说,住院期间听力改善更为显著。而 BSSHL 的发生可能涉及免疫机制。
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[Analysis of clinical characteristics and curative effects of 169 patients with bilateral sudden sensorineural hearing loss].

Objective: To analyze the clinical characteristics, curative effect related factors and follow-up situation of bilateral sudden sensorineural hearing loss (BSSHL). Methods: The clinical data of 169 patients(338 ears) with BSSHL were retrospectively summarized, and the demographic characteristics, predisposing factors, concomitant symptoms and diseases, and audiological characteristics were statistically described. Additionally, influencing factors of curative effect and prognosis were statistically analyzed. Results: Among the 169 patients, 50.9% (86/169) of patients had at least one incentive, with cold and fatigue being the most common incentives(both 23/169). There were high rates of accompanying symptoms including tinnitus (150/169, 88.8%) and dizziness (100/169, 59.2%). Hypertension(49/169, 29.0%)and diabetes(23/169, 13.6%)were the most common concomitant diseases observed. Most cases exhibited all frequencies involvement, with flat type and total deafness type accounting for 83.1%(281/338 ears). The most common degree of hearing loss was total deafness(86/338 ears), with approximately 60.1%(203/338 ears) of the cases being severe or worse. The total effective rate of treatment was only 29.0%, but it increased to 39.5% for patients with course of disease≤14 days, however, when course of disease>30 days, the effective rate decreased sharply to 3.6%, showing a significant difference between these two groups(χ2=13.776,<0.01). Different types of hearing curves showed statistically significant difference in efficiency(χ2=14.782, P<0.01). Comparing the hearing improvements of 28 BSSHL patients from admission to discharge and from discharge to follow-up, it was found that the hearing improvement of the two groups showed statistically significant difference at the frequencies of L-250 Hz, L-500 Hz, R-125 Hz, R-250 Hz and R-500 Hz(Z value was -2.495, -3.083, -3.970, -3.388 and -3.264 respectively, all P<0.05). The proportion of patients with elevated serum IgE was much higher than that of the normal population. Conclusion: BSSHL patients suffer from serious hearing loss, and many also experience tinnitus and vertigo symptoms. Due to the poor efficiency of treatment, it is better for patients to be treated within 30 days of onset. For patients of hearing loss in the low frequency range, hearing improvement is more significant during hospitalization. And the occurrence of BSSHL may involve an immune mechanism.

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