突发性聋预后的影响因素

The prognostic factors for sudden deafness

目的探讨影响突发性聋预后的相关因素,为预后判断及临床治疗提供指导。方法对112例(124耳)突发性聋病例作回顾性研究,应用SAS软件对患者性别、年龄、患耳侧别、单双耳发病、发病至就诊时间、是否伴有眩晕、是否伴有耳鸣、听力损失程度、听力图类型、疗程等进行单因素分析及多因素Logistic逐步回归分析;并将完成两疗程以上治疗的60耳的最终疗效与第一疗程后的疗效进行了对比。结果单因素分析及多因素logistic逐步回归分析均显示仅眩晕(P=0.0454.)、发病至就诊时间(P=0.0015)及听力图类型(P=0.0006)等因素与预后有关(P<0.05);完成两疗程以上治疗的60耳患者的最终疗效与第一疗程后的疗效相比明显提高(P<0.0001)。结论突聋早期治疗可以提高疗效,不伴眩晕者预后较好,听力图类型为低频下降型、中频下降型者疗效好于其他类型。对第一疗程未能痊愈的患者,继续治疗能够显著提高疗效。

Objective To study the prognostic factors for patients with sudden deafness, and to provide guidance for clinical treatments. Methods 112 cases（124 ears）with sudden deafness were reviewed retrospectively. SAS software was applied for single factor analysis and multiple factors Logistic regression analysis on the factors of gender, age, lesion side, lateral or bilateral, time duration between onset and treatment, accompanied vertigo or tinnitus, the degree of hearing loss and audiogram type. There were 60 ears completed at least two courses of treatment. The effects after the first and the last course were compared. Results Vertigo（P=0.0454）, time duration between onset and treatment （P=0.0015） and audiogram type（P=0.0006） were correlated with the prognosis （P〈0.05）. Ultimate efficacy after the two courses of treatment was found improved significantly in 60 ears in comparison to that after the first treatment （P〈0.0001）. Conclusion Early treatment could improve outcomes of sudden deafness. A better clinical efficacy trended to be observed in patients without vertigo, or with low and middle frequency hearing loss. Continuous treatment could improve efficacy for those who failed in the first course treatment.