伴对侧耳感音神经性聋的突发性聋患者72例临床分析  

Clinical analysis for unilateral sudden sensorineural hearing loss with preexisting contralateral sensorineural hearing loss

作　　者：孙常领[1] 雷霞 沈佳[1] SUN Changling;LEI Xia;SHEN Jia(Department of Otolaryngology Head and Neck Surgery,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu,214062,China)

机构地区：[1]江南大学附属医院耳鼻咽喉头颈外科

出　　处：《中国耳鼻咽喉头颈外科》2019年第12期678-681,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：江苏省自然科学基金(BK20160195);无锡市青年医学人才项目(QNRC054)

摘　　要：目的探讨伴对侧耳感音神经性聋的突发性聋(unilateral sudden sensorineural hearing loss with preexisting sensorineural hearing loss in the contralateral ear,USSHLwCSHL)患者的临床特点、治疗效果,加深对该疾病的认识,提高诊治水平。方法回顾性分析72例USSHLwCSHL患者的发病特点、听力学检查、血液学检查和治疗效果等临床资料,并与同期发病的65例对侧耳听力正常的突发性聋(unilateral sudden sensorineural hearing loss with contralateral normal hearing,USSHLwCNH)患者进行比较。结果USSHLwCSHL组的发病年龄明显高于USSHLwCNH组[(65.17±8.29)岁vs(46.71±11.54)岁,P<0.001)],且男性患者比例更高(女性/男性:32/40 vs 45/20,P<0.01);USSHLwCSH组下降型听力曲线占比(37.50%)明显高于USSHLwCNH组(18.46%),而上升型听力曲线占比(0)明显低于USHLwCNH(18.46%)(P<0.01);两组之间血小板平均体积、血纤维蛋白原、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇,载脂蛋白a1和载脂蛋白b等血液学检查指标无明显差异;USSHLwCSHL组的治疗有效率(33.33%)明显低于USSHLwCNH(55.38%,P<0.01)。结论USSHLwCSHL更多见于高龄患者,且男性患者比例较高,与USSHLwCNH组比,USSHLwCSHL组的上升型听力曲线较少,而下降型听力曲线更多、治疗效果较差。OBJECTIVE To investigate the clinical characteristics,treatment outcomes of unilateral sudden sensorineural hearing loss with preexisting contralateral sensorineural hearing loss(USSHLwCSHL).METHODSThe clinical data of 72 cases of USSHLwCSHL were retrospectively analyzed,including the characteristics of the disease,audiological examination,hematological examination,and therapeutic effect,and compared with those of 65 cases of USSHL with contralateral normal hearing(USSHLwCNH).RESULTS There was a statistically significant difference in the age(65.17±8.29 vs46.71±11.54,P<0.001)and sex ratio(Fmale/Male:32/40 vs 45/20,P<0.01)between the two groups.In the USSHLwCSHL group,there were more descending audiograms(37.50%)and less ascending types(0)compared to those of USSHLwCNH(18.46%,10.77%respectively,P<0.01).No statistical difference was found between the two groups with respect to the laboratory tests including mean platelet volume,fibrinogen,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,Apo A1 and Apo B.The treatment effective rate of USSHLwCSHL patients(33.33%)was significantly lower than those of USSHLwCNH patients(55.38%,P<0.01).CONCLUSION USSHLwCSHL has a male preponderance and tends to occur in advanced age in our cohort.Compared to USSHLwCNH patients,USSHLwCSHL patients have more descending audiograms,less ascending audiograms and poorer treatment outcomes.

关 键 词：听觉丧失 突发性 听觉丧失 感音神经性 对侧耳 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]