突发性耳聋患者血栓弹力图的特征

Changes of thromboelastography in patients with sudden deafness

目的:探讨不同分型的突发性耳聋(sudden sensorineural hearing loss,SSHL)患者血栓弹力图(thromboelastography,TEG)各项指标的特征。方法:选择2016年7月至2017年6月在徐州医科大学附属医院耳鼻咽喉科住院治疗的81例SSHL患者为研究对象。其中低频下降型15例,高频下降型12例,平坦下降型31例,全聋型23例。另选同期在本院择期行鼻中隔矫正术的体健患者20名作为对照组。所有研究对象进行TEG检测,分析TEG的5个指标(K值,R值,α角,MA值和CI值)的变化。结果:与对照组比较,SSHL组TEG各参数中K值降低,α角、MA值和CI值升高,差异具有统计学意义(P<0.05);R值降低不明显,与对照组比较差异无统计学意义(P>0.05)。全聋型的K值、α角、M A值和CI值与平坦型、高频型和低频型比较差异均有统计学意义(P<0.0 5);平坦型的K值、α角和MA值与高频型、低频型比较差异均有统计学意义(P<0.05),CI值与高频型比较差异无统计学意义(P>0.05),与低频型比较差异有统计学意义(P<0.05);高频型的K值、α角、MA值和CI值与低频型比较差异无统计学意义(P<0.05);R值各组间变化不明显,差异无统计学意义(P>0.0 5)。结论:SSH L组较对照组T EG的多项指标存在明显差异,且在SSH L的不同分型中存在相应的变化。TEG检测对不同类型SSHL发病机制的探讨及临床用药的指导均有实用价值。

Objective： To investigate the values changes of thromboelastography（TEG） in various types of sudden deafness patients. Methods： A total of 81 patients with sudden deafness in the Department of Otorhinolaryngology from July 2001 to June 2017 in the Affiliated Hospital of Xuzhou Medical University were enrolled. Among them, there were 15 cases of low-frequency descending type group, 12 cases of High-frequency descending type group, 31 cases of flat-descending type group, 23 cases of total deafness type group. In the same period, 20 healthy patients with nasal septum correction were selected as a control group. All of them were tested to detect changes of TEG values, including K value, R value, α Angle, MA value and CI values. Results： K value were significantly smaller, α angle, MA value and CI value were significantly larger in patients with sudden deafness than in control group（P〈0.05）; R values showed no significant differences（P〈0.05）. The parameters of TEG（such as K value, α angle, MA value and CI value） in total deafness type group were significantly different from those in low-frequency descending type group, high-frequency descending type group and flat-descending type group（P〈0.05）; the parameters of TEG（such as K value, α angle and MA value） in flat-descending type group were significantly different from those in low-frequency descending type group and High-frequency descending type group（P〈0.05）. The CI value in flat-descending type group was significantly different from those in low-frequency descending type group（P〈0.05）, while there was no significant different from those in High-frequency descending type group（P〈0.05）; while there was no significant difference in the parameters of TEG（such as K value,α angle, MA value and CI value） between low-frequency descending type group and high-frequency descending type group（P〈0.05）. The R values showed no significant differences among all the deafness types. Conclusion： The parameters of TEG（such as K value, α angle, MA value and CI value） in the deafness group were significantly difference when compared with in the control group, and there were corresponding changes in the different types of sudden deafness. TEG plays a role in evaluation of different types of deafness and the guidance of clinical medication.