主要听力耳突发性聋临床特征与预后分析  

Clinical Characteristics and Prognosis of Sudden Sensorineural Hearing Loss in the Dominant Hearing Ear

作　　者：轩晗 闫文亚 李晓华[1] 温莹莹 张紫玉 张帆[1] 卢星[1] 李璐[1] 张文静[1] 孟娟[1] 秦兆冰[1] XUAN Han;YAN Wenya;LI Xiaohua;WEN Yingying;ZHANG Ziyu;ZHANG Fan;LU Xing;LI Lu;ZHANG Wenjing;MENG Juan;QIN Zhaobing(Department of Otolaryngology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院耳鼻喉科,郑州450052

出　　处：《中华耳科学杂志》2024年第5期744-748,共5页Chinese Journal of Otology

摘　　要：目的探讨主要听力耳突发性聋患者临床特征、治疗前后最大言语识别率(wordrecognition score,WRS)和语频纯音平均阈值(pure-toneaverage,PTA)及治疗效果。方法分析2020年1月至2022年12月期间于郑州大学第一附属医院耳鼻喉科住院治疗的单侧突发性聋患者156例,根据其对侧耳是否患有感音神经性聋分为对侧耳正常组及对侧耳异常组,分析对侧耳异常患者主要听力耳突发性聋的临床特征、听力学特点、疗效及预后,并与同期住院治疗的对侧耳正常突发性聋患者进行比较。结果对侧耳异常组患者在年龄、男性和伴发高脂血症及高血压的比例均高于对侧耳正常组,差异有统计学意义(P<0.01),且其现病耳初始语频PTA及WRS更差(P<0.05)。两组患者现病耳治疗前后平均语频PTA及WRS均有显著改善,差异有统计学意义(P值均<0.001),但治疗后对侧耳正常组平均语频PTA及WRS均好于对侧耳异常组,差异有统计学意义(P值均<0.05);治疗总有效率对侧耳正常组(51.3%)高于对侧耳异常组(28.2%)(P<0.05)。治疗前后现病耳语频PTA与WRS的相关性分析均为高度相关(P<0.001),但存在分离现象。结论主要听力耳突发性聋患者更趋高龄化、男性比例较高、易伴发高脂血症和高血压,其听力损失程度更重、言语识别能力更低,是治疗效果较差的影响因素。WRS和语频PTA联合应用能更好地评估患者对语言的感知和分辨,言语识别能力较纯音测听阈值更敏感,其变化及与纯音听阈变化的分离对突发性聋进一步认识和疗效评估具有重要意义。Objective To report clinical characteristics including the word recognition score(WRS)and speech-frequency pure-tone average threshold(PTA)before and after treatment and prognosis of sudden sensorineural hearing loss(SSHL)in the dominant hearing ear.Methods Patients with unilateral SSHL who were hospitalized from January 2020 to December 2022(n=156)were divided into two groups based on contralateral ear hearing(with or without sensorineural deafness).Clinical characteristics,audiological patterns and prognosis were compared between the two groups.Results Patients with contralateral hearing loss showed higher proportions of older age,male gender,hyperlipidemia and hypertension than those without contralateral hearing loss(P<0.05),with worse initial speechfrequency PTA and WRS in the affected ear(P<0.05).Following treatment,Speech-frequency PTA and WRS in the affected ear improved significantly in both groups(P<0.001),more so in those without contralateral hearing loss(P<0.05),with a total effectiveness rate of 51.3%,compared to 28.2%in patients with contralateral hearing loss(P<0.05).Preand post-treatment speech-frequency PTA and WRS were highly negatively correlated(P<0.001),with exceptions in some cases.Conclusion Patients with SSHL in the dominant hearing ear are more likely to be older and male,have hyperlipidemia and hypertension,and show worse hearing loss and speech discrimination,which are also risk factors for poor prognosis.WRS is more sensitive in predicting prognosis than speech-frequency PTA.Its independent changes,separate from speech-frequency PTA,may help prognostic assessment in patients with SSHL.

关 键 词：突发性聋 对侧耳听力 语频纯音平均阈值 言语识别率 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]