不同颅内压状态下乙状窦源性耳鸣患者的临床特征分析

Clinical characteristics of pulsatile tinnitus induced by sigmoid sinus abnormalities with different intracranial pressure

目的 探讨高颅内压和正常颅内压状态下乙状窦源性耳鸣患者临床特征的差异。方法 入选乙状窦源性耳鸣患者66例(乙状窦沟骨板缺损55例,乙状窦憩室11例)。基于颅脑磁共振静脉成像(magnetic resonance venography,MRV)用横窦狭窄指数(index of transverse sinus stenosis,ITSS)将患者分为高颅内压组41例,正常颅内压组25例。回顾性分析两组患者的人口学资料、临床指标、耳鸣特征及血生化检查的差异。结果 高颅内压组和正常颅内压组体重指数(BMI)分别是24.98 kg/m^(2)(22.87 kg/m^(2),28.46 kg/m^(2))和24.01 kg/m^(2)(20.34 kg/m^(2),25.03 kg/m^(2)),耳鸣障碍评估量表(tinnitus handicap inventory,THI)评分分别是45.59±23.47和33.84±20.13。高颅内压组的BMI和THI评分均明显高于正常颅内压组(P分别是0.047和0.042)。两组间年龄、性别、左右利手、耳鸣侧别、平均动脉压、耳鸣持续时间、耳鸣频率、耳鸣响度及血生化指标均无显著性差异。结论 高颅内压和正常颅内压的乙状窦源性耳鸣患者临床特征存在差异,具体表现为高颅内压的耳鸣患者BMI和THI评分明显升高。

OBJECTIVE To analyze the clinical characteristics of pulsatile tinnitus induced by sigmoid sinus abnormalities in high and normal intracranial pressure states.METHODS There were 66 patients of pulsatile tinnitus induced by sigmoid sinus abnormalities,including 55 cases of sigmoid sinus wall dehiscence and 11 cases of sigmoid sinus diverticulum.The index of transverse sinus stenosis(ITSS) was used to assess intracranial pressure in magnetic resonance venography(MRV).We obtained 41 cases in intracranial hypertension group and 25 cases in normal intracranial pressure group.The age,gender,handedness,tinnitus lateralization,mean arterial pressure(MAP),body mass index(BMI),tinnitus duration,tinnitus frequency,tinnitus loudness,tinnitus handicap inventory(THI) and blood biochemical examination were recorded to analyze.RESULTS The BMI was 24.98 kg/m~2(22.87 kg/m~2,28.46 kg/m~2) and 24.01 kg/m~2(20.34 kg/m~2,25.03 kg/m~2) and THI score was 45.59±23.47 and 33.84±20.13 in intracranial hypertension group and normal intracranial pressure group,respectively.Compared with normal intracranial pressure group,the BMI and THI of intracranial hypertension group were significantly increased(P was 0.047 and 0.042 respectively).No significant difference were found in other indicators.CONCLUSION There are some different characteristics in pulsatile tinnitus induced by sigmoid sinus abnormalities in high and normal intracranial pressure states,which manifest obviously increased BMI and THI score in pulsatile tinnitus patients with intracranial hypertension.