突发性聋听力损失程度及疗效的多因素分析

Multifactorial analysis of the degree of hearing loss and outcome in patients with sudden hearing loss

目的:探讨突发性聋(SHL)听力损失严重程度及疗效与临床指标的关系。方法:选取273例SHL患者,按照入院时首次纯音测听受累耳累及频率的平均听阈行三分位数分组,单因素、多因素有序logistic回归评估SHL患者初始听力水平与临床指标的关系,Spearman相关系数分析SHL疗效与临床指标的相关性。结果:与较低听力损失(≤50 dB HL)患者相比,较高听力损失(>50 dB HL)患者伴有较高的中性粒细胞、单核细胞、甘油三酯、血红蛋白、纤维蛋白原、葡萄糖、中性粒细胞/高密度脂蛋白(NHR)、单核细胞/高密度脂蛋白、单核细胞/淋巴细胞、年龄、眩晕以及较低的血小板/淋巴细胞、高密度脂蛋白和较差的最终听阈(均P<0.05)。多因素有序logistic回归分析显示NHR、年龄是SHL患者初始听力损失的独立危险因素。NHR、中性粒细胞/淋巴细胞(NLR)、病程、听力曲线类型、最终听阈与疗效呈显著负相关。结论:NHR和NLR值越高、从发病到就诊时间越长、听力损失程度越严重的SHL患者疗效越差,而NHR、年龄值越高SHL患者初始听力损失越严重,不同类型听阈曲线及年龄的SHL患者听力损失程度及疗效不同。

Objective:To investigate the relationship between the severity and curative effect of hearing loss and clinical indicators in patients with sudden hearing loss(SHL).Methods:The Spearman correlation coefficient was used to analyze the correlation between the efficacy of SHL and clinical indicators.A total of two hundred and seventy-three patients with SHL were selected and divided into three quantile groups according to the average hearing threshold of the the involved ear frequency of the first pure tone audiometry at admission.Univariate and multivariate ordered logistic regression were used to evaluate the relationship between initial hearing level and clinical indicators of SHL patients.The Spearman correlation coefficient was used to analyze the correlation between efficacy of SHL and clinical indicators.Results:Compared with patients with lower hearing loss(≤50 dB HL),patients with higher hearing loss(>50 dB HL)had higher Neutrophil,Monocyte,Triglycerides,Hemoglobin,Fibrinogen,Glucose,Neutrophil/high-density lipoprotein cholesterol ratio(NHR),Monocyte/high-density lipoprotein cholesterol ratio,Monocyte/lymphocyte cell ratio,age,dizziness,and lower Platelet/lymphocyte cell ratio and High-density lipoprotein cholesterol,and poor final hearing threshold.Multivariate logistic regression showed that NHR and age were independent risk factors for initial hearing loss in SHL patients.And the NHR,Neutrophil/lymphocyte cell ratio(NLR),course of disease,type of hearing curve,and final hearing threshold were significantly negatively correlated with curative effect.Conclusion:SHL patients with higher NHR and NLR values,the longer time from onset to visit,and the more severe hearing loss had worse efficacy.However,SHL patients with higher NHR and age values had greater initial hearing loss,the degree of hearing loss and curative effect are different in SHL patients with different types of hearing threshold curve and age.