脑白质高信号与突发性聋及预后的关系  

Association of sudden sensorineural hearing loss and its prognosis with the brain white matter hyperintensity

作　　者：罗冬 李国梁 齐伟平[2] 陈丹 LUO Dong;LI Guoliang;QI Weiping;CHEN Dan(Department of Neurology,Baoji Municipal Central Hospital,Baoji,721008,China;Depart­ment of Otolaryngology Head and Neck Surgery,Baoji Municipal Central Hospital)

机构地区：[1]宝鸡市中心医院神经内科,陕西宝鸡721008 [2]宝鸡市中心医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第7期523-527,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：陕西省宝鸡市卫生局科研立项课题(No:201510)。

摘　　要：目的:探讨脑白质高信号(WMH)与突发性聋(简称突聋)的关系及对突聋预后的影响。方法:纳入2019年6月-2020年6月期间以单侧突聋住院的患者50例(突聋组)和年龄、性别匹配无突聋病史的常规体检者50例(对照组)进行病例对照研究。所有纳入对象完善3.0T头颅磁共振检查,采用Fazekas量表对脑室周围白质高信号(PVWMH)和深部白质高信号(DWMH)进行独立评分,比较突聋组与对照组Fazekas评分和Fazekas评分频率分布情况,采用有序logistic回归研究突聋患者预后与WMH的关系。结果:突聋患者WMH的Fazekas评分明显高于对照组(PVWMH:P=0.004,DWMH:P=0.010);突聋组与对照组Fazekas评分频率分布差异有统计学意义(PVWMH:P=0.036,DWMH:P=0.047);有序logistic回归结果显示突聋患者不合并WMH即Fazekas=0是突聋预后良好的独立预测因素(P=0.025,OR=12.779)。结论:突聋患者合并脑白质高信号较无突聋者更常见,不合并脑白质高信号较合并脑白质高信号的突聋患者预后更好。Objective: To explore the relationship between white matter hyperintensity(WMH) and sudden sensorineural hearing loss(SSHL) and evaluate the influence of WMH on the prognosis of SSHL. Methods: Fifty hospitalized unilateral SSHL patients and 50 age and gender matched routine physical examination individuals without SSHL history from June 2019 to June 2020 were included for a case-control study. All included subjects underwent 3.0 Tesla cranial magnetic resonance examination, and the Fazekas scale was applied to evaluate periventricular white matter hyperintense(PVWMH) and deep white matter hyperintense(DWMH). Fazekas score and distribution proportions of Fazekas score was compared between SSHL and control. Ordered logistic regression was used to study the relationship between prognosis of SSHL and WMH. Results: The Fazekas score of WMH in SSHL group was significantly higher than that of control group(PVWMH: P=0.004, DWMH: P=0.010);There was a significant difference in the distribution proportions of Fazekas scores between SSHL and control(PVWMH: P=0.036, DWMH: P=0.047);The results of ordered logistic regression showed that patients without WMH(Fazekas=0) is an independent predictor of good prognosis in SSHL(P=0.025, OR=12.779). Conclusion: The prevalence of WMH in SSHL patients was higher than that of control. SSHL patients without WMH has a better prognosis than those with WMH.

关 键 词：聋 突发性 脑白质高信号 脑小血管病 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]