右心声学造影检测突发性耳聋患者右向左分流的临床价值

Clinical value of right heart contrast echocardiography in detecting right-to-left shunt in patients with sudden deafness

摘要:

目的 应用右心声学造影(cTTE)探讨突发性耳聋与右向左分流(RLS)之间的关系，以期为突发性耳聋的临床诊疗提供新的研究方向和有力的理论依据。方法 纳入100例突发性耳聋患者作为突聋组，另纳入100例健康人群作为对照组，与突聋组年龄、性别相匹配，比较突聋组与对照组间RLS的阳性率、分流量和分流类型有无差别。应用cTTE将突聋组分为RLS阳性组与阴性组，比较两组在性别、伴发症状、合并症、耳聋分型及疗效等方面有无差异。结果 突聋组与对照组在RLS阳性率、大量分流率及分流类型方面差异均具有统计学意义(P均＜0.05)。突聋组中RLS阳性患者比RLS阴性患者年轻(P＜0.05)。结论 突发性耳聋的发生与RLS有关，cTTE检查结合Valsalva 动作可以有效地提高RLS的检出率。

Abstract:

Objective To explore the relationship between sudden deafness and right-to-left shunt (RLS) by contrast transthoracic echocardiography (cTTE) so as to provide new research direction and powerful theoretical basis for the clinical diagnosis and treatment of sudden deafness.Methods One hundred patients with sudden deafness were selected as the sudden deafness group and 100 healthy subjects as the control group. The incidence of RLS, the size and type of shunt between the sudden deafness group and the control group were compared. The sudden deafness group was subdivided into RLS positive group and RLS negative group by cTTE, and the differences in gender, concomitant symptoms, comorbidities, deafness classification and efficacy between the two subgroups were analyzed.Results There were significant differences in the incidence of RLS, mass flow rate and shunt type between the sudden deafness group and the control group (all P＜0.05). In the sudden deafness group, the patients with positive RLS were younger than those with negative right-to-left shunt (P＜0.05).Conclusion The occurrence of sudden deafness is related to RLS, and the detection rate of RLS can be effectively improved by using cTTE and Valsalva maneuver.