血浆乳酸含量与突发性聋预后的相关性研究  

The Correlation between Plasma Lactic Acid Level and Prognosis of Sudden Deafness

作　　者：杨帆[1] 陈函 黄宁[1] 陈贤明[1] 王茂鑫[1] YANG Fan;CHEN Han;HUANG Ning;CHEN Xianming;WANG Maoxin(Department of Otorhinolaryngology,the 900th Hospital of the PLA Joint Logistics Support Force,Fuzhou 350025,China)

机构地区：[1]中国人民解放军联勤保障部队第900医院耳鼻咽喉科头颈外科,福州350025

出　　处：《中华耳科学杂志》2022年第2期261-265,共5页Chinese Journal of Otology

摘　　要：目的 探讨血浆乳酸含量与突发性聋患者的预后是否存在相关性。方法 回顾性分析2016年09月至2019年06月在我院耳鼻咽喉头颈外科就诊住院治疗的临床资料完整的突发性聋患者114例,比较不同听力下降程度、不同类型(低频下降型、高频下降型、平坦型和全聋型)及疗效(痊愈、显效、有效和无效)的突发性聋患者血浆乳酸含量。结果 不同程度听力下降的突发性聋患者血浆乳酸含量有差异(F=8.696, P<0.001);26-55dB与>91dB(P=0.002),56-90dB与>91dB(P<0.001)之间存在统计学差异。不同类型的突发性聋患者的血浆乳酸含量比较有统计学差异(F=5.658, P<0.001),低频下降型与全聋型比较(P<0.001),平坦型与全聋型比较(P=0.018),存在统计学差异。不同疗效组的血浆乳酸含量比较有统计学差异(F=8.711, P<0.001),采用最小显著性差异法(Least Significance Difference, LSD)两两分析,发现痊愈组与显效组(P=0.48),痊愈组与有效组(P=0.001),痊愈组与无效组(P<0.001),显效组与无效组(P=0.011)之间存在统计学差异。多元线性回归分析中,有效组的血浆乳酸是痊愈组的1.673倍,无效组血浆乳酸含量是痊愈组的1.704倍。结论 血浆乳酸含量与突发性聋患者听力下降程度、分型、预后有关,同时血浆乳酸含量与预后呈负相关。血浆乳酸可作为突发性聋的预后参考指标。Objective To investigate the correlation between plasma lactic acid level and prognosis of sudden deafness. Methods Clinical data of 114 patients with sudden deafness seen from Sep.2016 to June 2019 in our otolaryngology head and neck surgery clinic were retrospectively analyzed, including degree of hearing loss, audiogram patterns,treatment outcomes and plasma lactic acid levels. Results Plasma lactic acid levels varied with the degree of hearing loss(F=8.696, P<0.001)(P=0.002 between hearing loss <30 dB HL and >60 dB HL, and P<0.001 between hearing loss = 30-59 dB HL and >60 dB HL). It also varied with audiogram patterns(F=5.658, P<0.001)(P<0.001 between lowfrequency loss and total loss, and P=0.018 between flat type and total loss). The plasma lactic acid levels were different among different treatment outcome groups(F=8.711, P<0.001). Least significance difference analysis showed statistically significant differences between patients with complete hearing recovery and those with significant improvement(P=0.48), those showing some improvement(P=0.001) and those showing no improvement(P<0.001), and between patients with significant improvement and those showing no improvement(P=0.011). After controlling other factors and compared to patients with complete hearing recovery, plasma lactic acid level was higher by 1.673 fold in patients with only hearing improvement, and by 1.704 folds in those showing no change. Conclusion The level of plasma lactic acid is related to the degree of hearing loss, hearing loss patterns and treatment outcomes in patients with sudden deafness. It can be used as a prognostic indicator in sudden deafness.

关 键 词：突发性聋 血浆乳酸 预后 

分 类 号：R764[医药卫生—耳鼻咽喉科]