突发性聋患者应用甲泼尼龙冲击治疗导致血压或血糖升高的影响因素分析

Analysis of factors influencing the increase of blood pressure and fasting glucose in patients with sudden hearing loss treated with methylprednisolone pulse therapy

目的探究甲泼尼龙冲击治疗突发性聋过程中导致患者血压或血糖升高的影响因素。方法纳入2021年1月至2022年12月期间应用甲泼尼龙冲击治疗的突发性聋患者188例,收集患者临床基本资料,记录治疗过程中患者血压及血糖水平,分析甲泼尼龙导致突发性聋患者血压或血糖升高的影响因素。运用Kaplan-Meier曲线分析住院期间患者不良反应发生情况。结果188例患者中共有68例(36.17%)患者出现血压或血糖升高,20例患者判定为与甲泼尼龙很可能相关,48例患者判定为可能相关。多因素分析结果显示,年龄较大、双侧突发性聋及合并使用地塞米松进行鼓膜内注射给药是突发性聋患者血压或血糖升高的危险因素(P<0.05)。进一步分析发现,血糖升高的影响因素和血压升高的影响因素相同。Kaplan-Meier分析结果显示,合并使用地塞米松的患者、双侧突聋的患者血压或血糖水平升高的概率较高(P<0.05)。结论甲泼尼龙冲击治疗会影响突发性聋患者的血压或血糖水平,年龄、突聋部位及是否合并使用地塞米松可能是甲泼尼龙冲击治疗导致患者血压或血糖升高的影响因素。

AIM To explore the factors contributing to the increase in blood pressure or fasting glucose levels in patients with sudden hearing loss treated with methylprednisolone.METHODS A total of 188 patients treated with methylprednisolone for sudden hearing loss in a hospital from January 2021 to December 2022 were included in this study.Clinical characteristics were collected,blood pressure and fasting glucose levels were recorded,and the factors that contribute to the increase in blood pressure and fasting glucose levels in these patients were recorded.Kaplan-Meier curves were used to describe the incidence of adverse reactions during hospitalization.RESULTS A total of 188 patients were included in this study,of whom 68 patients(36.17%)exhibited elevated levels of blood pressure or fasting glucose,20 patients were assessed as very likely related to methylprednisolone,and 48 patients as possibly related.The multifactorial analysis showed that increased age,bilateral sudden hearing loss,and concurrent intratympanic dexamethasone injections were significant risk factors for the elevation of blood pressure or fasting glucose levels(P<0.05).Further research indicated that the factors influencing the increase in fasting glucose mirrored those affecting blood pressure.Kaplan-Meier analysis showed that patients using topical dexamethasone and those with bilateral sudden hearing loss had a higher likelihood of experiencing elevated blood pressure or fasting glucose levels(P<0.05).CONCLUSION Methylprednisolone pulse therapy can elevate blood pressure or fasting glucose levels in patients with sudden hearing loss.Age,the site of sudden hearing loss,and concurrent use of topical dexamethasone may be influencing factors in the elevation of blood pressure or fasting glucose levels caused by methylprednisolone pulse therapy.