1.Shanxi Medical University,Taiyuan;2.Department of Otolaryngology Head and Neck Surgery,the Second Hospital of Shanxi Medical University,Taiyuan
目的 分析单侧全聋型突发性聋的一般临床特征，探讨影响预后的相关因素。方法 回顾2019年9月至2021年5月于我院耳鼻喉科住院治疗的127例单侧全聋型突发性聋患者的临床资料，包括一般情况、伴随症状、伴发疾病、实验室检查、治疗效果等，采用卡方检验及二元Logistic回归分析性别、年龄、患耳侧别、发病至就诊时间、伴发疾病（高血压、糖尿病、心脏病）、伴随症状（耳鸣、眩晕/头晕）、实验室检查（叶酸、维生素B12、同型半胱氨酸）对预后的影响。结果 本研究127例单侧全聋型突发性聋患者，伴耳鸣者113例（88.98%），伴眩晕/头晕者91例（71.65%），总有效率为41.73%。单因素分析显示年龄（P=0.016＜0.05）、发病至就诊时间（P=0.003＜0.05）及是否伴眩晕/头晕（P=0.017＜0.05）与预后相关，差异有统计学意义。性别、患耳侧别、伴发基础疾病（高血压、糖尿病、心脏病）、耳鸣、实验室检查（叶酸、维生素B12、高同型半胱氨酸）对预后影响差异没有统计学意义。多因素分析显示发病至就诊时间（P=0.006＜0.05）、是否伴眩晕/头晕（P=0.037＜0.05）为预后的独立危险因素，发病至就诊时间≥3天组是＜3天组有效率的0.311倍（OR=0.311，95%CI为0.134-0.720，P=0.006），伴眩晕/头晕者有效率是不伴者有效率的0.385倍（OR=0.385，95%CI为0.157-0.944，P=0.037）。结论 单侧全聋型突发性聋常伴耳鸣、眩晕/头晕，年龄≥40岁、发病至就诊时间≥3天、伴眩晕/头晕提示预后不佳，其中发病至就诊时间≥3天以及伴发眩晕/头晕为其独立危险因素，可为临床预后评判及治疗提供理论依据。
Objective The objective is to analyze the general clinical features of unilateral total sudden deafness,and to explore the prognostic factors.Methods The clinical data of 127 cases with unilateral total sudden deafness were retrospectively studied from September 2019 to May 2021 in the Department of Otolaryngology of our hospital,including general conditions, accompanying symptoms, accompanying diseases, hearing characteristics, laboratory examination, treatment effect, etc.Chi-square test and multivariate binary Logistic regression were used to analyze the effects of gender, age, affected ear side, the time before treatment, accompanying diseases (hypertension, diabetes, heart disease), accompanying symptoms (tinnitus,vertigo/dizziness), and laboratory tests (folic acid, vitamin B12, homocysteine) on prognosis.Results Among 127 cases of unilateral total sudden deafness,113 cases (88.98%) were accompanied by tinnitus,91 cases (71.65%) by vertigo, the total effective rate was 41.73%. Single-factor analysis revealed a statistically prognostic association between age (P=0.016<0.05), the time before treatment (P=0.003<0.05), and associated with dizziness / dizziness (P=0.017<0.05).However,there was no statistical significance in the influence of gender,affected ear,associated basic diseases (hypertension,diabetes,heart disease), tinnitus and laboratory tests (folic acid, vitamin B12, high homocysteine) on prognosis.Multivariate analysis showed that the time before treatment(P=0.006<0.05) and whether with the vertigo/dizziness (P=0.037<0.05) were independent risk factors for prognosis.The effective rate of the group with the time before treatment ≥3 days vs the group with the time before treatment＜3 days(OR=0.311,95%CI=0.134-0.720,P=0.006).The effective rate of the group with vertigo/dizziness vs the group without vertigo/dizziness(OR=0.385,95%CI=0.157-0.944,P=0.037).Conclusion Unilateral total sudden deafness is often accompanied by tinnitus and vertigo/dizziness. And the age ≥40 years,the time before treatment ≥3 days and accompanied by vertigo/dizziness suggest poor prognosis.And,the time before treatment ≥3 days and accompanied by vertigo/dizziness are independent risk factors,which can provide theoretical basis for clinical prognosis evaluation and treatment of unilateral total sudden deafness.