突发性聋不同听力曲线类型与血脂代谢异常的相关性分析

Correlation analysis between hearing curve type and dyslipidemia in sudden sensorineural hearing loss

目的分析突发性聋患者血脂代谢特点,探讨突发性聋不同听力曲线类型发病及疗效与血脂代谢的相关性。方法回顾性分析2012年1月—2019年7月就诊于湖南中医大学第一附属医院耳鼻咽喉头颈外科的385例突发性聋患者的临床资料,其中男163例,女222例,年龄12~85岁,平均46岁。观察突发性聋患者的年龄、不同听力曲线类型及临床疗效与血脂代谢的相关性。结果 385例突发性聋患者,听力曲线呈平坦下降型和全聋型患者与低频下降型和高频下降型患者比较,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)呈升高趋势,高密度脂蛋白(HDL-C)呈下降趋势。不同年龄段突聋患者TC、LDL-C比较,40~69岁段患者明显高于10~39岁段患者,差异具有统计学意义(P<0.05)。统计两个年龄段不同构成,40~69岁年龄段与10~39岁年龄段患者听力曲线类型比较,全聋型(39.9%vs 32.8%)、平坦下降型(51.2%vs 47.4%)。不同临床疗效患者之间TC、TG、HDL-C、LDL-C比较,差异无统计学意义(P>0.05)。结论不同听力损失曲线类型之间发病机制可能不同,血脂可能通过血液黏滞度增加、血管内皮细胞损伤等机制在平坦下降型和全聋型患者发病中起重要作用。

Objective To analyze the characteristics of blood lipid metabolism in patients with sudden sensorineural hearing loss(SSNHL), and to explore the relationships between the incidence and therapeutic effect and hearing curve type in SSNHL.Methods Clinical data of 385 cases with SSNHL treated in our department from Jan 2012 to July 2019 were analyzed retrospectively to observe the correlations between patients’ age, type of hearing curve, curative effect and blood lipid.Results A total of 385 cases were collected, including 163 males and 222 females. They ranged in age from 12 to 85 years with an average age of 46. Compared with the patients with hearing curve of low-frequency and high-frequency descending types, the levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C) of those with flat descending type and total deafness were increased, and the levels of high density lipoprotein(HDL-C) were decreased. The levels of TC and LDL-C in 40~69 age group were higher than those in 10~39 group, and the differences were statistically significant(P>0.05). As for the hearing curve, the rates of total deafness type of the 40~69 age group and 10~39 age group were 39.9% and 32.8%, and those of the flat descending type were 51.2% and 47.4%. There were no significant differences in levels of TC, TG, HDL-C and LDL-C among the patients with different therapeutic effects.Conclusions The pathogenesis of SSNHL with different types of hearing curve may be different. Blood lipids may play an important role in the pathogenesis of SSNHL in patients with flat descending curve and total deafness through the mechanism of increasing blood viscosity and vascular endothelial cell damage.