镫骨肌反射阈存在的突聋患者预后及影响因素

Prognosis and influencing factors in sudden deafness patients with acoustic stapedius reflex threshold

目的分析镫骨肌反射阈存在的突聋患者的预后情况,探讨其影响因素。方法回顾性分析2018年1月至2021年12月收治的282例镫骨肌反射阈存在的突聋患者的临床资料,采用Excel进行数据整理,SPSS 26.0对收集的资料进行描述性分析及统计分析,对性别、年龄、就诊时间、是否伴有耳鸣、眩晕、基础疾病(糖尿病、高血压、冠心病)、听力曲线类型、听力损失程度、镫骨肌反射阈、镫骨肌反射阈与纯音听阈差值(A-T)等因素进行统计学分析。结果282例镫骨肌反射阈存在的突发性聋患者中,治愈101例,显效8例,有效54例,无效119例,总有效率57.8%。耳聋侧别(P=0.907)、伴随症状(P眩晕=0.686,P耳鸣=0.534)、基础疾病(P高血压=0.338,P糖尿病=0.262,P心脏病=0.780)、镫骨肌反射阈(P0.5 kHz=0.152,P1.0 kHz=0.701,P2.0 kHz=0.810)、镫骨肌反射阈与纯音听阈差值(P0.5 kHz A-T=0.413,P2 kHz A-T=0.092)在镫骨肌反射阈存在的突聋患者预后有效组和无效组组间差异无统计学意义,而年龄(P=0.022)、性别(P=0.001)、突聋就诊时间(P<0.001)、听力曲线类型(P=0.004)、听力损失程度(P=0.008)和1 kHz镫骨肌反射阈与听阈差值(P1 kHz A-T<0.001)是预后有效的影响因素。结论在镫骨肌反射阈存在的突聋患者中,性别、年龄、就诊时间、听力曲线类型、听力损失程度和1 kHz镫骨肌反射阈与听阈差值对耳聋预后有影响,镫骨肌反射阈值变化与突聋患者预后差异无统计学意义,但可以通过1 kHz镫骨肌反射阈与听阈差值预估突聋患者疗效,提高患者治疗信心。

Objective Analyze the prognosis of sudden deafness patients with acoustic stapedius reflex threshold and explore its influencing factors.Methods This study was a retrospective analysis of the clinical data of 282 patients who suffered sudden deafness with acoustic stapedius reflex threshold from January 2018 to December 2021.Excel was used for data processing,and SPSS 26.0 was used for descriptive and statistical analysis of the collected data.Statistical analyses were conducted on factors such as gender,age,time of medical treatment,tinnitus,vertigo,basic diseases(diabetes,hypertension,coronary heart disease),hearing curve type,degree of hearing loss,acoustic stapedius reflex threshold,difference between acoustic stapedius reflex threshold and hearing threshold(A-T).Results Among 282 cases of sudden deafness with acoustic stapedius reflex threshold,101 cases were cured,8 cases were markedly effective,54 cases were effective,and 119 cases were ineffective.The total effective rate was 57.8%.Deafness side(P=0.907),accompanying symptoms(Pvertigo=0.686,Ptinnitus=0.534),basic diseases(Phypertension=0.338,Pdiabetes=0.262,Pcoronary heart disease=0.780),acoustic stapedius reflex threshold(P0.5 kHz=0.152,P1.0 kHz=0.701,P2.0 kHz=0.810),the difference between acoustic stapedius reflex threshold and the pure tone hearing threshold(P0.5 kHz A-T=0.413,P2 kHz A-T=0.092)of patients who suffered sudden deafness with acoustic stapedius reflex threshold had no significant difference in prognosis.However,age(P=0.022),sex(P=0.001),visit time of sudden deafness(P<0.001),type of hearing curve(P=0.004),degree of hearing loss(P=0.008)and difference between 1 kHz acoustic stapedius reflex threshold and hearing threshold(P1 kHz A-T<0.001)were effective prognostic factors.Conclusion In sudden deafness patients with acoustic stapedius reflex threshold,gender,age,visit time of sudden deafness,type of hearing curve,degree of hearing loss and difference between 1 kHz acoustic stapedius reflex threshold and hearing threshold have an impact on the prognosis of deafness.The change of acoustic stapedius reflex threshold has no significant correlation with the prognosis of sudden deafness patients.However,the effect of sudden deafness patients can be estimated by the 1 kHz acoustic stapedius reflex threshold and hearing threshold difference to improve patients confidence in treatment.