术前血脂水平对乙状窦病变搏动性耳鸣患者乙状窦骨壁重建术疗效的影响  

Effect of preoperative blood lipid levels on the therapeutic efficacy of sigmoid sinus bone wall reconstruction in patients with pulsatile tinnitus caused by sigmoid sinus disease

作　　者：吴静[1] 任韶康 郑乾佑 朱秋阳 李慎玲[1] 张晓雯[1] 付涛[1] WU Jing;REN Shaokang;ZHENG Qianyou;ZHU Qiuyang;LI Shenling;ZHANG Xiaowen;FU Tao(Department of Otorhinolaryngology Head and Neck Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266035,China)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266035

出　　处：《精准医学杂志》2025年第2期162-165,共4页Journal of Precision Medicine

摘　　要：目的探讨术前血脂对乙状窦病变搏动性耳鸣患者乙状窦骨壁重建术疗效的影响。方法选择2019年5月—2022年9月我院耳鼻咽喉头颈外科收治的乙状窦病变搏动性耳鸣行乙状窦骨壁重建术的患者43例,依据患者术后耳鸣改善程度分为痊愈组、有效组和无效组。收集并比较患者的一般资料以及术前血清中低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白A1(APOA1)、载脂蛋白B(APOB)、游离脂肪酸(FFA)、三酰甘油(TG)、胆固醇(TC)水平及APOB/APOA1比值。结果43例患者中术后痊愈24例,有效14例,无效5例。患者血清LDL、APOB、FFA、TC水平及APOB/APOA1比值均显著高于正常参考值,APOA1水平显著低于正常参考值(t=3.683~9.713,P<0.05),且无效组患者的血清APOB/APOA1比值显著高于其他两组(F=7.527,q=3.120、3.650,P<0.05)。结论乙状窦骨壁重建术能够有效缓解乙状窦病变搏动性耳鸣患者的病情,术前血脂异常可能通过干扰骨重建降低手术疗效;术前评估血脂水平,尤其是血清APOB/APOA1比值,有助于预测手术效果,从而为患者提供高效治疗。Objective To investigate the effect of preoperative blood lipid levels on the therapeutic efficacy of sigmoid sinus bone wall reconstruction in patients with pulsatile tinnitus caused by sigmoid sinus disease.Methods A total of 43 patients with pulsatile tinnitus caused by sigmoid sinus disease who underwent sigmoid sinus bone wall reconstruction in Department of Otorhinolaryngology Head and Neck Surgery in our hospital from May 2019 to September 2022 were enrolled in this study,and accor-ding to the degree of improvement in tinnitus after surgery,they were divided into cured group,response group,and non-response group.Related data were collected and compared between groups,including general information,the serum levels of low-density lipoprotein(LDL),high-density lipoprotein,apolipoprotein A1(APOA1),apolipoprotein B(APOB),free fatty acid(FFA),triglyceride,and total cholesterol(TC),and APOB/APOA1 ratio before surgery.Results Among the 43 patients,24 were cured,14 showed response,and 5 showed no response.The serum levels of LDL,APOB,FFA,and TC and APOB/APOA1 ratio were significantly higher than the normal reference values,while the level of APOA1 was significantly lower than the normal refe-rence value(t=3.683-9.713,P<0.05),and the non-response group had a significantly higher APOB/APOA1 ratio than the ot-her two groups(F=7.527,q=3.120,3.650,P<0.05).Conclusion Sigmoid sinus bone wall reconstruction can effectively alleviate the symptoms of patients with pulsatile tinnitus caused by sigmoid sinus disease,and abnormal blood lipid levels before surgery may compromise the efficacy of surgery by interfering with bone reconstruction.Preoperative evaluation of blood lipid levels,especially APOB/APOA1 ratio,can help to predict surgical outcome,thereby providing efficient treatment for patients.

关 键 词：耳鸣 血脂异常 颅窦 憩室 骨重建 治疗结果 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]