老年突发性耳聋患者血液流变学指标变化及其与病情转归的关系

Discussion on the changes in hemorheology indicators and of elderly patients with sudden deafness and their relationship with disease progression

目的探讨老年突发性耳聋患者血液流变学指标变化及其与病情转归的关系。方法选取丽水市人民医院2018年6月至2020年6月收治的122例老年突发性耳聋患者为耳聋组,同期在本院体检且年龄匹配的110名健康志愿者为对照组。比较两组对象血液流变学指标(包括高切全血黏度、低切全血黏度、血浆黏度、血小板聚集率、红细胞压积等),以及耳聋组不同听力曲线类型患者血液流变学指标;比较突发性耳聋患者好转组与恶化组临床资料,采用多因素logistic回归分析影响老年突发性耳聋患者病情转归的独立危险因素。结果突发性耳聋患者病情恶化50例,病情好转72例。耳聋组患者各项血液流变学指标均明显高于对照组(均P<0.05)。耳聋组不同听力曲线类型患者各项血液流变学指标比较,差异均有统计学意义(均P<0.05)。恶化组患者吸烟、饮酒、重度听力受损、听力曲线类型为全聋型以及合并高血压、高血脂、糖尿病的比例均明显高于好转组,高切全血黏度、低切全血黏度、血浆黏度、血小板聚集率、红细胞压积等血液流变学指标均明显高于好转组,差异均有统计学意义(均P<0.05)。吸烟、饮酒、重度听力受损、全聋型、高血压、高血脂、糖尿病、高切全血黏度、低切全血黏度、血浆黏度、血小板聚集率、红细胞压积等均是影响老年突发性耳聋患者病情转归的独立危险因素(OR=5.150、8.908、7.988、6.659、5.924、9.161、5.171、7.632、5.053、5.902、7.225、5.086,均P<0.05)。结论老年突发性耳聋患者各项血液流变学指标均偏高,且这些指标是影响病情转归的独立危险因素。

Objective To investigate the changes in hemorheology indicators of elderly patients with sudden deafness and their relationship with disease progression.Methods One hundred and twenty-two elderly patients with sudden deafness admitted to Lishui People's Hospital from June 2018 to June 2020 were selected as study group,and 110 healthy volunteers matched for age were recruited as control group.The hemorheology indicators of the two groups were compared,including high-shear whole blood viscosity,low-shear whole blood viscosity,plasma viscosity,platelet aggregation rate,hematocrit,etc.The hemorheology indicators of sudden deafness patients with different types of hearing curve were compared.The clinical data of patients with sudden deafness were compared between the patients with improved and deteriorating condition.Multiple logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of elderly patients with sudden deafness.Results The condition of sudden deafness worsened in 50 cases and improved in 72 cases.The hemorheology indicators of the study group were all higher than those of the control group(all P<0.05).There were statistically significant differences in hemorheology indicators among patients with different hearing curve types in study group(all P<0.05).The proportions of smoking,drinking,severe hearing impairment,total deafness,hypertension,hyperlipidemia and diabetes in the patients with deteriorating condition were significantly higher than those with improved condition.The high-shear whole blood viscosity,low-shear whole blood viscosity,plasma viscosity,platelet aggregation rate and hematocrit of the patients with deteriorating condition were all higher than those with improved condition(all P<0.05).Smoking,drinking,severe hearing impairment,hearing curve of total deafness,high-shear whole blood viscosity,low-shear whole blood viscosity,plasma viscosity,platelet aggregation rate,red blood cell pressure product,combined hypertension,combined hyperlipidemia,and combined diabetes mellitus were all risk factors for the deterioration of the disease(OR=5.150,8.908,7.988,6.659,5.924,9.161,5.171,7.632,5.053,5.902,7.225,5.086,all P<0.05).Conclusion The hemorheology indicators in elderly patients with sudden deafness are high,and these indexes are independent risk factors affecting the outcome of the disease.