颈部血管彩超血流参数与突发性耳聋患者听力损失类型、程度的关系研究  

Relationship between blood flow parameters of cervical vascular color Doppler ultrasound and the type,degree and curative effect of hearing loss in patients with sudden deafness

作　　者：云丽媛 李海朋 王竣凤 董亚男 郭宁 丁瑞美 张雪萍 康欣 YUN Liyuan;LI Haipeng;WANG Junfeng;DONG Yanan;GUO Ning;DING Ruimei;ZHANG Xueping;KANG Xin(Ultrasound Department of Tangshan Vocational and Technical College Affiliated Hospital,Hebei Tangshan 063000,China;Department of Neurology,Affiliated Hospital of Tangshan Vocational and Technical College,Hebei Tangshan 063000,China)

机构地区：[1]唐山职业技术学院附属医院超声科,河北唐山063000 [2]唐山职业技术学院附属医院神经内科,河北唐山063000

出　　处：《中国实验诊断学》2024年第7期782-787,共6页Chinese Journal of Laboratory Diagnosis

基　　金：河北省医学科学研究课题计划项目(20221832)。

摘　　要：目的探讨颈部血管彩超血流参数与突发性耳聋(SSNHL)患者听力损失类型、严重程度关系的关系研究。方法选取2020年4月—2023年3月唐山职业技术学院附属医院收治的167例SSNHL患者,参照相关指南中听阈曲线类型,将患者可分为低频下降型(n=88)、高频下降型(n=46)、全频下降型(n=33);根据听力损失严重程度可分为轻度组(74例)、中度组(62例)和重度组(31例)。比较不同类型及不同听力损失程度SSNHL患者的颈部血管彩超血流参数[颈动脉、椎动脉的舒张末期血管速度(EDV)、收缩期峰值血流速度(PSV)、阻力指数(RI)、搏动指数(PI)]。Spearman相关性分析法分析患者听力损失程度与彩超血流参数的关系。对所有患者进行相应治疗后,根据疗效分为有效组144例、无效组23例。采用受试者工作特征曲线(ROC)分析颈部血管彩超血流参数对SSNHL治疗效果的预测价值。结果高频下降型患者颈动脉、椎动脉EDV和PSV高于低频下降型和全频下降型(P<0.05),而低频下降型和全频下降型患者上述参数比较差异无统计学意义(P>0.05)。与轻度组比较,重度组、中度组患者的颈动脉、椎动脉EDV、PSV及椎动脉RI更高(P<0.05),与中度组比较,重度组患者上述参数更高(P<0.05)。Spearman相关性分析结果显示,颈动脉EDV、PSV和椎动脉EDV、PSV及RI均与SSNHL患者听力损失程度呈负相关关系(P<0.05)。无效组颈动脉、椎动脉EDV、PSV、RI均低于有效组,差异有统计学意义(P<0.05)。ROC曲线结果显示,颈动脉EDV、PSV、RI及椎动脉EDV、PSV、RI单独预测SSNHL治疗无效的曲线下面积(AUC)为0.602、0.637、0.717、0.628、0.633、0.826。结论颈部血管彩超血流参数与不同类型、不同听力损失严重程度及疗效的SSNHL患者关系密切,并对临床诊治具有一定的应用价值。Objective To investigate the relationship between blood flow parameters of neck color Doppler ultrasound and the type, severity and therapeutic effect of hearing loss in patients with sudden deafness(SSNHL).Methods 167 SSNHL patients admitted to our hospital from April 2020 to March 2023 were selected.According to the types of hearing threshold curves in relevant guidelines, the patients could be divided into low-frequency decline type(n=88),high-frequency decline type(n=46) and full-frequency decline type(n=33).According to the severity of hearing loss, they could be divided into mild group(74 cases),moderate group(62 cases) and severe group(31 cases).Blood flow parameters(end-diastolic vascular velocity(EDV),peak systolic blood velocity(PSV),resistance index(RI) and pulsation index(PI)) of carotid and vertebral arteries in patients with SSNHL with different types and degrees of hearing loss were compared.Spearman correlation analysis was used to analyze the relationship between the degree of hearing loss and blood flow parameters of color Doppler ultrasound.After corresponding treatment, all patients were divided into effective group(144 cases) and ineffective group(23 cases) according to the treatment effect.Receiver operating characteristic curve(ROC) was used to analyze the predictive value of cervical blood flow parameters in the treatment of SSNHL.Results The EDV and PSV of carotid artery and vertebral artery in high-frequency descending type were higher than those in low-frequency descending type and full-frequency descending type(P<0.05),but there was no statistically significant difference between low-frequency descending type and full-frequency descending type(P>0.05).The EDV,PSV and RI of carotid artery and vertebral artery in severe group and moderate group were higher than those in mild group, and the above parameters in severe group were higher than those in moderate group, with statistical significance(P<0.05).Spearman correlation analysis showed that carotid EDV,PSV,vertebral EDV,PSV and RI were

关 键 词：突发性耳聋 颈动脉彩超 听阈曲线类型 预测价值 

分 类 号：R543.4[医药卫生—心血管疾病]