伴眩晕的单侧全聋型突发性聋预后相关因素分析

Clinical Factors Affecting Prognosis of Unilateral Total Sudden Deafness with Vertigo

目的探讨相关临床因素对伴眩晕的单侧全聋型突发性聋患者预后的影响。方法回顾性分析136例伴眩晕的单侧全聋型突发性聋患者的临床病例资料,采用单因素及多因素Logistic回归分析性别、年龄、侧别、初诊时间(发病到开始治疗时间)、是否患有伴随疾病(高血压、糖尿病)、冷热试验结果及视频头脉冲试验结果对预后的影响。结果136例患者总有效率52.21%(71/136)。单因素分析显示:年龄、初诊时间、冷热试验结果、视频头脉冲试验结果与预后存在关联性(P<0.05);性别、侧别、是否患有伴随疾病(高血压、糖尿病)与预后无显著关联性(P>0.05)。多因素分析显示:年龄>50岁患者听力恢复有效率是≤50岁患者的0.349倍(OR=0.349,95%CI为0.161~0.757,P=0.008);初诊时间>14天患者听力恢复有效率是≤14天患者的0.370倍(OR=0.370,95%CI为0.163~0.843,P=0.018);冷热试验异常患者是正常者听力恢复有效率的0.297倍(OR=0.297,95%CI为0.111~0.792,P=0.015);视频头脉冲试验异常患者是正常者听力恢复有效率的0.351倍(OR=0.351,95%CI为0.158~0.780,P=0.010)。结论高龄、较长的初诊时间、冷热试验异常、视频头脉冲试验异常提示伴眩晕的单侧全聋型突发性聋患者预后不良。

Objective The objective is to identify clinical factors potentially affecting the prognosis in patients with unilateral total sudden deafness and vertigo.Methods Clinical data from 136 patients with unilateral total sudden deafness and vertigo were analyzed retrospectively,univariate and multivariate logistic regression models were used to analyze the influence of gender,age,side affected,time before treatment,comorbidities(high blood pressure,diabetes,etc),caloric test results and video head impulse test results on prognosis.Results Treatments were effective in 52.21%(71/136)of the 136 patients.Univariate analysis showed that age,time before treatment,caloric test results and video head impulse test results were correlated with prognosis(P<0.05),but not gender,side affected or comorbidities(P<0.05).Multivariate analysis showed worse hearing recovery in patients aged>50 years as compared to patients aged≤50 years(OR=0.349,95%CI=0.161-0.757,P=0.008),when treatment was delayed by>14 days vs≤14 days(OR=0.370,95%CI=0.163-0.843,P=0.018),in patients showing abnormal vs normal caloric test results(OR=0.297,95%CI=0.111-0.792,P=0.015),and in patients with abnormal vs normal video head impulse test results(OR=0.351,95%CI=0.158-0.780,P=0.010).Conclusion Advanced age,delay of treatment,abnormal caloric and video head impulse test results indicate poor prognosis in unilateral total sudden deafness with vertigo.