双侧突发性聋27例临床分析

A clinical analysis of 27 cases of simultaneous bilateral sudden sensorineural hearing loss

目的:比较双侧同时发病的突发性聋(Si-BSSHL)与单侧突发性聋(USSHL)的临床特点和治疗效果。方法:回顾性分析27例Si-BSSHL患者的临床资料,包括发病特点、临床表现、听力学检查、血液学检查及治疗效果等,并与同期发病的139例USSHL患者进行比较。结果:Si-BSSHL组的发病年龄\[(65.85±9.17)岁\]明显高于USSHL组\[(56.95±13.18)岁\],差异有统计学意义(P<0.01);2组男女比例差异无统计学意义(P>0.05);Si-BSSHL伴眩晕、耳胀满感和既往患有高血压、糖尿病、冠心病、中风的比例与USSHL相比差异无统计学意义(P>0.05),伴耳鸣的比例明显低于USSHL组(P<0.05);Si-BSSHL组听力损失程度分布和听力曲线类型与USSHL组相比差异有统计学意义,Si-BSSHL组治疗前PTA和极重度听力损失的比例明显低于USSHL组(P<0.05),下降型听力曲线明显多于USSHL组(P<0.01);Si-BSSHL组的纤维蛋白原明显高于USSHL组(P<0.05),血小板平均体积、甘油三酯、叶酸等指标与USSHL组比较差异无统计学意义(P>0.05);Si-BSSHL组治疗总有效率为44.44%,USSHL组为41.73%,2组差异无统计学意义(P>0.05)。结论:Si-BSSHL更多见于高龄患者,女性比例较高,与USSHL相比,Si-BSSHL听力损失程度较轻,极重度聋患者所占比例较少,下降型听力曲线更多,治疗效果无明显差异。

Objective:To compare the clinical characteristics and therapeutic effects between simultaneous bilateral sudden sensorineural hearing loss(Si-BSSHL)and unilateral sudden sensorineural hearing loss(USSHL).Method:The clinical data of 27 cases of Si-BSSHL were retrospectively analyzed,including the characteristics of the disease,clinical manifestations,audiological examination,hematological examination,and therapeutic effect,and compared with those of 139 cases of USSHL.Result:There was a statistically significant difference in the age(65.85±9.17 vs 56.95±13.18,P<0.01)and no significant difference in sex ratio(P>0.05)between the two groups.The proportion of Si-BSSHL patients with vertigo,ear fullness,hypertension,diabetes,coronary heart disease and stroke had no statistical difference compared with those of USSHL(P>0.05),the proportion of patients with tinnitus in Si-BSSHL group was significantly lower than that in USSHL group(P<0.05).The distribution of hearing loss degree and the type of audiometry in Si-BSSHL group were significantly different from those in USSHL group,PTA before treatment and the proportion of profound hearing loss in Si-BSSHL group was significantly lower than that in USSHL group(P<0.05),descending audiometry type was more common in Si-BSSHL group compared to USSHL(P<0.01).Fibrinogen in Si-BSSHL group was significantly higher than that in USSHL group(P<0.05).No significant difference was found between the two groups with respect to mean platelet volume,blood lipid and folic acid(P>0.05).The total treatment effective rate in Si-BSSHL group was 44.44%,while that in USSHL group was 41.73%,there was no significant difference between the two groups(P>0.05).Conclusion:Si-BSSHL has a female preponderance and tends to occur in advanced age in our cohort.Compared to USSHL patients,Si-BSSHL patients have less profound hearing loss and more descending audiograms,and the proportion of patients with extremely severe deafness is relatively small.There is no significant difference in the therapeutic effect between the two groups.