儿童先天性感音神经性耳聋与脑白质病变的关系

Relationship between sensorineural hearing loss and brain white matter lesions in children

目的探讨儿童感音神经性耳聋(SNHL)与脑白质病变(WML)的关系。方法收集SNHL患儿436例,其中有WML者196例(A组),对患儿进行MR检查。收集同期无SNHL因他病接受颅脑MR检查的患儿720例,选取其中仅有WML者118例作为对照(B组)。依据改良Scheltens量表对脑室旁白质区(枕叶、额叶和侧脑室)和深部白质区(颞叶、额叶、顶叶、枕叶)各部位WML进行评分,并进行统计学分析。结果A组WML患儿占所有SNHL患儿的44.95%(196/436),B组WML患儿占无SNHL者的16.39%(118/720)。A组平均年龄小于B组(P=0.009)。A组侧脑室带状高信号灶评分高于B组(P<0.05)。额叶帽状高信号灶和枕叶帽状高信号灶评分差异均无统计学意义(P均>0.05)。A组深部白质区颞叶、额叶、顶叶WML评分均高于B组(P均<0.01),两组枕叶WML评分差异无统计学意义(P>0.05)。A组与B组脑室旁白质区与深部白质区各部位WML评分总和差异有统计学意义(P<0.05)。结论SNHL患儿WML发生率高、发病年龄较小,WML较严重。

Objective To explore the relationship between sensorineural hearing loss （SNHL） and cerebral white matter lesions （WML） in children. Methods A total of 436 children with SNHL were collected, and there were 196 children with WML among them （group A）. MR examination was performed on group A. Meanwhile, 720 children without SNHL receiving brain MR examination due to other diseases were collected, and there were 118 children with WML among them as control （group B）. WML in each part of periventricular white matter region （frontal lobe, occipital lobe and lateral ventri- cle） and deep white matter region （temporal lobe, frontal lobe, parietal lobe） were scored according to modified Scheltens scale, and statistical analysis was performed. Results WML children in group A accounted for 44. 95% （196/436） in children with SNHL. WML children in group B accounted for 16.39% （118/720） in children without SNHL. Average age in group A was less than that in group B （P=0. 009）. The score of lateral ventricle hyperintensity lesion in group A was higher than that of group B （P〈0.05）. The score difference of frontal lobe cap hyperintensity lesion and occipital lobe cap hyperintensity lesion in two groups had no statistical significance （both P〉0. 05）. WML score of deep white matter regions （temporal lobe, frontal lobe, parietal lobe） in group A were all higher than those of group B （all P〈0. 05）, and score of occipital lobe had no statistical significance （P〉0. 05）. The total WML score in each part of periventricular white matter region and deep white matter region in two groups had statistical difference （P〈0. 05）. Conclusion SNHL children have a high occurrence rate of WML, and onset the age is relatively small, WML is relatively more serious.