单侧突发性聋与椎基底动脉影像学特征的相关性研究

Correlation between unilateral sudden deafness and imaging features of vertebrobasilar artery

目的探讨单侧突发性聋(简称突聋)与椎基底动脉影像学特征间的关系。方法收集2014-2018年在山西医科大学第一医院被诊断为单耳突聋,且临床检验及影像学资料完整的患者175例,分析其听力损失侧别及程度与椎动脉、基底动脉特点间的关系。结果椎动脉(χ^2=8.031,P=0.045)及基底动脉(χ^2=5.091,P=0.034)狭窄/弯曲与听力损失侧别有关。听力损失预测因素的单变量分析结果显示,左侧听力损失患者与右侧(OR=2.89,95%CI为1.77~2.77,P=0.036)及双侧椎动脉狭窄/迂曲(OR=4.43,95%CI为1.49~13.23,P=0.008)有关,无基底动脉狭窄/迂曲与右侧听力损失(OR=0.31,95%CI为0.11~0.90,P=0.030)相关,其他因素无统计学意义。年龄和性别匹配的多变量分析结果显示,右侧椎动脉狭窄/迂曲与左耳听力损失有关(OR=2.83,95%CI为1.05~7.67,P=0.040)。患者基底动脉狭窄/迂曲与否与听力损失程度不存在统计学差异(χ^2=3.339,P=0.068)。突聋患者听力损失的程度与椎动脉(χ^2=3.897,P=0.273)及基底动脉(χ^2=3.339,P=0.068)的影像学特征无关。结论在突聋患者中,听力损失的侧向性与椎基底动脉是否狭窄/迂曲有关,右侧椎动脉狭窄/迂曲与左耳听力损失有关。

Objective To investigate the correlation between unilateral sudden deafness and the imaging features of vertebrobasilar artery. Methods This study included 175 patients diagnosed with unilateral sudden deafness in our hospital between 2014 and 2018, who had complete laboratory and imaging data. Data were analyzed in order to determine the relationship between the side and degree of hearing loss and the imaging characteristics of vertebral and basilar arteries. Results A stenosis/tortuosity of vertebral(χ^2=8.031, P=0.045)and basilar arteries(χ^2=5.091, P=0.034)was found to be related to hearing loss side. The univariate analysis results of hearing loss predictors demonstrated that left-sided hearing loss in patients is related to right-sided(odds ratio [OR]=2.89, 95% confidence interval [CI]: 1.77-2.77, P=0.036)and bilateral vertebral artery stenosis/tortuosity(OR=4.43, 95% CI: 1.49-13.23, P=0.008). Basilar artery stenosis/tortuosity on neither side is related to right-sided hearing loss in patients(OR=0.31, 95% CI: 0.11-0.90, P=0.030). Other evaluated factors were not statistically significant. Multivariate analysis matched by age and sex demonstrated that stenosis/tortuosity of the right vertebral artery was related to left-sided hearing loss(OR=2.83, 95% CI: 1.05-7.67, P=0.040), whereas no statistically significant difference was observed for the relationship between stenosis/tortuosity of basilar artery and hearing loss(χ^2 = 3.339, P=0.068). The degree of hearing loss in patients with sudden deafness is not related with the imaging features of the vertebral(χ^2 = 3.897, P=0.273)and basilar arteries(χ^2 = 3.339, P=0.068). Conclusion In patients with sudden deafness, the lateral nature of hearing loss is influenced by stenosis/tortuosity of the vertebrobasilar artery, whereas stenosis/tortuosity of the right vertebral artery is related to hearing loss in the left ear.