突发性聋患者血清脂质、脂蛋白及载脂蛋白水平的分析

目的：为了探讨血清脂质代谢与突发性聋（突聋）的关系。方法：检测了２２例突聋患者及２７例对照者的血清甘油三酯、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白ＡＩ及载脂蛋白Ｂ１００的含量。结果：经统计分析发现：突聋患者的甘油三酯水平升高（Ｐ＜０．０５），载脂蛋白Ｂ１００降低（Ｐ＜００５），而胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白ＡＩ与对照组比较差异无显著性（Ｐ＞００５）。结论：本组突聋患者体内存在脂类代谢异常，脂类代谢，尤其甘油三酯代谢异常可能与突聋的发生有关     

突发性聋患者血脂分析

目的 研究血脂与突发性聋(突聋)发病的相关性,为血脂某些指标较高的人群提供预防措施,降低突聋发病率。 方法 检测68例突聋患者(突聋组)及同期住院的80例非突聋患者(对照组)血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白a(Apo-A)和载脂蛋白β(Apo-β)的水平,统计分析两组间各血脂指标的差异。 结果 突聋组与对照组间甘油三酯(TG)差异有统计学意义(P<0.05),其余各指标差异无统计学意义(P>0.05);不同听力学曲线及不同听力下降程度的患者之间血脂各指标差异无统计学意义(P>0.05)。 结论 血脂中TG升高与突发性聋的发病有一定的关系,控制TG对预防突聋的发生可能有一定的意义。     

突发性耳聋患者前列环素I2和血栓素A2的含量变化

观察了突发性耳聋（突聋）患者治疗前后前列环素Ｉ２（ＰＧＩ２）和血栓素Ａ２（ＴＸＡ２）含量变化。结果发现：突聋患者治疗前与对照组比较ＴＸＡ２含量明显升高，ＰＧＩ２值有所下降；治疗后ＴＸＡ２下降，与对照组比较无统计学差异，而ＰＧＩ２值明显升高；２８例突聋患者治疗前后自身比较表明，治疗后ＴＸＡ２明显降低，ＰＧＩ２明显升高，与治疗前比较有统计学差异。提示ＴＸＡ２与ＰＧＩ２比例失调很可能是突聋的发病机理之一     

突聋病人血液流变学及血脂代谢研究

目的探讨血液流变学和血清脂质代谢变化与突发性耳聋(突聋)的关系。方法检测50例突聋病人及50例对照者血液流变学参数及血清中甘油三酯(TG)、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL-CH)、低密度脂蛋白胆固醇(LDL-CH)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)和脂蛋白(a)[LP(a)]的含量。结果突聋组全血比粘度、全血还原比粘度、血浆粘度和红细胞压积均增高,与对照组比较差异有显著性(P<0.01);突聋组TG、LDL-CH、ApoB和LP(a)水平较对照组显著增高(P<0.01),HDL-CH较对照组显著降低(P<0.01)。两组间CHO和ApoA无显著性差异(P>0.05)。结论 血液流变学及血脂代谢的异常改变可能与突聋的发生相关。     

突发性聋患者小脑下前动脉、基底动脉与血脂水平关系

目的　探讨突发性聋患者小脑下前动脉（anterior inferior cerebellar artery,AICA）、基底动脉（basal artery,BA）与血脂水平的关系。方法　收集突发性聋86例为观察组,健康对照者123例为正常对照组,测定血清总胆固醇（total cholesterol,CHO）、低密度脂蛋白（low density lipoprotein,LDL-C）、高密度脂蛋白（high density lipoprotein,HDL-C）及甘油三酯（triglyceride,TG）水平,磁共振成像检查AICA和BA,比较突发性聋患者AICA、BA与血脂水平关系。结果　正常对照组AICA、BA及血清HDL-C水平均高于观察组,血清CHO、LDL-C、TG均低于观察组,差异具有统计学意义（P＜0.05）。AICA、BA及血清HDL-C随突发性聋病情加重而逐渐递减,轻度组＞中度组＞重度组＞极重度组;血清CHO和LDL-C随突发性聋病情加重而逐渐递增,轻度组、中度组＜重度组＜极重度组;血清TG随突发性聋病情加重而逐渐递增,轻度组＜中度组、重度组＜极重度组,差异有统计学意义（P ＜0.05）。突发性聋患者AICA、BA与血清CHO、LDL-C、TG呈负相关,与血清HDL-C呈正相关,差异具有统计学意义（P＜0.05）。结论　突发性聋患者AICA、BA与血脂密切相关,随病情变化升高或降低,为突发性聋的病情评估提供参考依据。     

突发性聋患者血脂检测结果分析

目的探讨血脂水平对突发性聋发病的可能影响。方法以77例突发性聋(sudden sensorineural hearing loss,SSHL)患者(突聋组,左耳35例,右耳23例,双耳19例)和25例健康体检者(对照组)为研究对象,应用全自动生化仪检测两组对象血清总胆固醇(cholesterol,CHOL)、甘油三酯(triglyceride,TG)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)及低密度脂蛋白(low density lipoprotein cholesterol,LDL-C),比较两组结果。结果突聋组CHOL、TG及LDL-C高于对照组(P<0.05),HDL-C与对照组差异无统计学意义(P>0.05);左耳组、右耳组和双耳组CHOL、TG高于对照组(P<0.05),左耳组、右耳组和双耳组HDL-C、LDL-C与对照组差异无统计学意义(P>0.05);左耳组、右耳组和双耳组的CHOL、TG、HDL-C及LDL-C组间差异无统计学意义(P>0.05)。结论多数SSHL患者存在血脂异常,血脂紊乱可能增加SSHL的发病率。     

老年人良性阵发性位置性眩晕与血尿酸的关系

目的　探讨血尿酸水平和老年人良性阵发性位置性眩晕（benign paroxysmal positional vertigo,BPPV）之间的相关性。方法　收集2014年1月～2015年8月在我院住院≥60岁老年人102例BPPV患者作为BPPV组,并随机收集同期在我院≥60岁体检者85例作为对照组,分别测定血白蛋白、肌酐、尿酸、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、血压（收缩压、舒张压）,并收集记录二组病例心脑血管系统相关疾病及危险因素：高血压、糖尿病、冠心病、高血脂、脑梗死、脑出血、吸烟等病史。结果　BPPV组与对照组在性别、年龄、高血压史、糖尿病史、冠心病史、高血脂史、脑梗死史、脑出血史、吸烟史、甘油三酯、高密度脂蛋白、空腹血糖、肌酐、收缩压、舒张压等方面差异无统计学意义（P＞0.05）,但白蛋白、尿酸、总胆固醇、低密度脂蛋白在二组之间差异有统计学意义（P＜0.05）,BPPV组白蛋白、尿酸、总胆固醇、低密度脂蛋白显著高于对照组（P＜0.05）。采用多因素Logistic回归分析提示高尿酸、高低密度脂蛋白是老年人BPPV发病的危险因素。结论　血清尿酸增高与老年人BPPV发病具有相关性,是老年人BPPV发病的危险因素。     

血脂对突发性聋预后的影响

目的研究血脂对突发性聋预后的影响,以便为临床上采取合适的干预措施提供理论依据。方法分析晨起空腹的63例高频和全频下降型突聋患者静脉血中低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三脂(TG)、血清总胆固醇(TC)、载脂蛋白β(Apo-β)、载脂蛋白a(Apo-A)的水平,分析血脂各指标与听力恢复的关系。结果听力下降程度及不同听力下降频率的突发性聋患者之间血脂各个指标的差异均没有统计学意义(P>0.05);听力恢复的程度与血脂各指标的差异均没有统计学意义(P>0.05);Logistic回归分析表明,TG、TC水平与疗效相关(P<0.05),其余各指标与疗效关系不明显(P>0.05)。结论血脂对突发性聋预后可能有一定的影响,是否有需要专门的降脂治疗,尚需进一步研究。     

突发性聋患者血常规、血脂、血液流变学的水平及其与预后的相关性

目的检测突发性聋(Sudden deafness,SD)患者外周血血常规、血脂、血液流变学的水平,并与健康正常人相比,同时探讨这些指标与其疗效的关系。方法回顾性分析2018年1月至2019年6月148例突发性聋(简称突聋)患者的临床资料,与同期的160例健康对照者相比较,分析不同听阈曲线类型(低频下降型、平坦下降型、高频下降型及全聋型)的突聋患者血常规相关指标白细胞、中性粒细胞、淋巴细胞、平均血小板体积(mean platelet volume,MPV)、血小板/淋巴细胞比值(platelet lymphocyte ratio,PLR)及中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte,NLR),血脂相关指标(总胆固醇、甘油三酯),血液流变学(血浆粘度、全血粘度高切、全血粘度中切、全血粘度低切)的水平及其与突发性聋疗效的相关性。结果①突聋组血常规、血脂、血液流变学与对照组的比较:突聋组白细胞、中性粒细胞、淋巴细胞、MPV、NLR、PLR、总胆固醇、甘油三酯、全血粘度中切与对照组相比差异有统计学意义(P<0.05),其中突聋组患者白细胞、中性粒细胞、MPV、NLR、PLR、总胆固醇、全血粘度中切均较对照组升高,淋巴细胞、甘油三酯较对照组降低。突聋组血浆粘度、全血粘度高切、全血粘度低切较对照组升高,差异无统计学意义(P>0.05)。②不同类型听阈曲线突聋患者血常规、血脂、血液流变学的比较:低频下降型、平坦下降型、高频下降型及全聋型患者的白细胞、中性粒细胞、MPV、NLR、PLR与对照组相比明显升高;其淋巴细胞与对照组相比明显降低;低频下降型总胆固醇、全血粘度高切、中切、低切较对照组升高;平坦下降型总胆固醇、全血粘度高切、中切较对照组升高;全聋型总胆固醇、全血粘度高切较对照组升高,以上差异均有统计学意义(P<0.05)。高频下降型总胆固醇、全血粘度高切、中切、低切较对照组升高,各类型突聋患者与对照组的甘油三酯、血浆粘度差异,均无明显统计学意义(P>0.05)。③不同类型听阈曲线突聋患者不同疗效的血常规、血脂、血液流变学的比较:突聋组治疗无效组白细胞、中性粒细胞、NLR、血浆粘度、全血粘度高切、低切较治疗有效组升高;低频下降型治疗无效组的白细胞、中性粒细胞、NLR、全血粘度低切较治疗有效组升高;高频下降型治疗无效组的白细胞、中性粒细胞、全血粘度高切、中切、低切较治疗有效组升高;平坦下降型治疗无效组的白细胞、中性粒细胞、淋巴细胞、血浆粘度较治疗有效组升高;全聋型治疗无效组的白细胞、中性粒细胞、NLR、PLR较治疗有效组升高,以上差异均有统计学意义(P<0.05)。④突聋组患者血常规指标中白细胞、中性粒细胞、NLR与预后呈负相关性,血液流变学指标中的血浆粘度、全血粘度低切与预后呈负相关性。结论突聋患者可能存在炎症感染、脂代谢异常以及血流变学异常,同时发现突聋患者的白细胞、中性粒细胞、NLR、血浆粘度、全血粘度低切对其预后能起到一定的预测作用。临床工作中,我们应该关注突聋患者的血常规、血液流变学指标,可给予抗感染、降低血粘度等治疗,可能有助于其预后。     

耳后注射联合鼓室注射甲强龙治疗糖尿病合并突发性聋近期疗效观察

目的探讨耳后注射联合鼓室注射甲强龙治疗糖尿病合并突发性聋的治疗效果。方法将86例(89耳)突发性聋合并糖尿病患者随机分成三组,治疗组—耳后注射联合鼓室注射甲强龙组29例(29耳),对照组1-单纯鼓室注射甲强龙组27例(30耳),对照组2-单纯耳后注射甲强龙组30例(30耳),分别观察其近期疗效。结果治疗组、对照组1、对照组2的治疗有效率分别为82.76%(24/29)、66.67%(20/30)、70.00%(21/30),治疗组分别与对照组1、对照组2之间比较,有效率差异有统计学意义(P值均0.05)。对照组1与对照组2之间比较,有效率差异无统计学意义(P值0.05)。结论鼓室注射和耳后注射均是治疗突发性聋的有效方法,联合应用效果更佳,值得临床推广应用。     

Relationship between Sudden Sensorineural Hearing Loss and Vascular Risk Factors

Objective To explore the relationship between sudden sensorineural hearing loss(SSNHL) and vascular risk factors (including serum lipids and uric acid). Method This is a retrospective analysis of 100 cases of SSNHL seen at the Drum Tower Hospital, Nanjing Medical University, between Jan. 2007 and Apr. 20080 Patient history, blood test results and imaging scans were analyzed. Levels of triglyceride (TG), cholesterols (CHO), high density lipoprotein-cholesterol (HDL-CH), low density lipoprotein-cholesterol (LDL-CH), apolipoprotein AI (ApoAI), apolipoprotein B(ApoB) and uric acid(UA) from these patients were compared with a control group of 56 patients treated for vocal cord polyps or nasal septum deviation during the same period. Patients with hyperten-sion, diabetes, heart, brain, liver or kidney disorders are excluded from the present investigation. Results HDL-CH level was higher and UA level lower in the study group than the control group (P< 0.05). HDL-CH and UA showed no significant differences among different age-groups (P > 0.05). There were no significant differences in the levels of TG, CHO, LDL-CH, ApoAI and ApoB (P > 0.05). Conclusion These data indicate that metabolic disturbances of serum lipids and/or uric acid may be potential risk factors for SSNHL     

Coenzyme Q 10 and cardiovascular risk factors in idiopathic sudden sensorineural hearing loss patients.

OBJECTIVES: We investigated the association of idiopathic sudden sensorineural hearing loss (ISSNHL) with coenzyme Q (CoQ) and cardiovascular risk factors. STUDY DESIGN: A prospective study. SETTING: Hospital center. PATIENTS: Thirty Italian patients with ISSNHL and 60 healthy Italian subjects. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Evaluation of serum CoQ levels and cardiovascular risk factors (total cholesterol, low-density lipoprotein [LDL], homocysteine [HCY]). The results were compared with variance analysis and Student's t test. Univariate and multivariate analysis were used to evaluate the association between ISSNHL and CoQ, total cholesterol, LDL, and HCY levels. RESULTS: In our series, we found a significant association between ISSNHL and high total cholesterol (p < 0.05), high LDL (p = 0.021), and low CoQ (p < 0.05) levels. We did not find a significant association between ISSNHL and HCY levels. In the univariate analysis, low levels of CoQ, high levels of total cholesterol, and LDL were found to be significantly associated with ISSNHL. In the multivariate analysis, only high levels of total cholesterol and low levels of CoQ remained significantly associated with a high risk of sudden sensorineural hearing loss. CONCLUSION: The studies regarding the role of cardiovascular risk factors in ISSNHL are not conclusive. This is the first report regarding the association of ISSNHL and low serum levels of the antioxidant CoQ. Further studies are needed to investigate the role of antioxidants, including CoQ, in ISSNHL.     

阻塞性睡眠呼吸暂停低通气综合征患者血清代谢指标分析及其临床意义

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清代谢指标的改变及其临床意义。方法：对95例疑似OSAHS患者进行PSG检查,根据PSG结果将患者分为OsAHS组65例和非OSAHS组（对照组）30例。对所有患者抽取静脉血进行生化指标检测,记录尿素氮（BUN）、肌酐（Cr）、尿酸（UA）、空腹血糖（FG）、总胆固醇（Tc）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等代谢指标。根据AHI、LSaO2将患者进一步分为轻中度OsAHS组和重度0sAHS组、轻中度低氧组和重度低氧组,比较分析0sAHS组和对照组之间以及不同程度0sAHs组间上述代谢指标的差异。结果：OSAHs组血清Cr、UA、TG的含量明显高于对照组,HDL—C的含量明显低于对照组（P〈0．01或P〈0．05）,而BUN、FG、TC、LDL—C的血清含量在两组间的差异无统计学意义（P〉0．05）。轻中度OSAHS组患者血清TG含量明显低于重度0sAHS组（P〈0．01）,其他各项指标的差异均无统计学意义（P〉0．05）;轻中度低氧组血清BUN、UA和TG含量明显低于重度低氧组,HDL-C含量明显高于重度低氧组（P〈0．01或P〈0．05）;两组患者血清Cr、FG、TC和LDL—C含量则无显著性差异（P〉0．05）。结论：OSAHS对患者的代谢指标能够产生较大影响,引起代谢指标改变的主要因素是OSAHS所致的低氧血症和高碳酸血症。AHI值的高低不能很好地反映OSAHS患者的低氧程度,对代谢指标的影响较小,临床上应结合LSaO2对OSAHS患者的严重程度进行综合评判。     

地塞米松不同给药方式治疗突发性聋的疗效观察

目的:探讨地塞米松不同给药方式治疗突发性聋的疗效。方法:回顾性分析100例突发性聋患者,将其分为2组,A组(50例)全身静脉注射地塞米松,B组(50例)鼓室内注射地塞米松。结果:A、B组治疗总有效率分别为66%、68%,差异无统计学意义(P>0.05)。结论:不管全身方式给药,还是局部鼓室给药,使用地塞米松治疗突发性聋的疗效相仿。     

H.E.L.P.-Apherese bei der Behandlung des Hörsturzes

Disturbances of cochlear microcirculation are among the most discussed causes of sudden sensorineural hearing loss. Increased levels of cholesterol and fibrinogen seem to act as risk factors for inner ear disorders. Fibrinogen/LDL apheresis greatly reduces the concentration of plasma fibrinogen thus leading to improved cochlear blood flow. In a retrospective case series remission rates of 152 patients suffering from sudden sensorineural hearing loss and resistant to former treatment were investigated after treatment with a single apheresis. Complete remission was reported in 11% of patients, partial remission in 43%. 37% had no change of hearing threshold and 2% reported a decrease in hearing. Rates of complete remissions decreased from 22% within the first 2 weeks after onset of hearing loss to 14% after 6 weeks. In the same period of time rates of partial remissions decreased from 33% to 13%. The present study shows that apheresis achieved complete or partial remission in 54% of patients even after unsuccessful treatment with another therapy and the therapeutic window lies by approximately 6 weeks.     

Clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss

OBJECTIVES/HYPOTHESIS: The role of antiendothelial cell antibodies in systemic vasculitis has been reported. The aim of the study was to define the clinical associations of serum antiendothelial cell antibodies in patients with sudden sensorineural hearing loss. STUDY DESIGN: A prospective study in patients with sudden sensorineural hearing loss. METHODS: Serum samples were taken from 59 consecutive patients with sudden sensorineural hearing loss at time of presentation and from 28 normal control subjects. Indirect immunofluorescence assay was used to detect antiendothelial cell antibodies. RESULTS: The prevalence of antiendothelial cell antibody detection was 54% (32 of 59 patients), with a statistically significant difference between patients and control subjects (P =.0004). Antiendothelial cell antibody positivity was significantly associated with absent recovery of hearing loss (P =.0020). CONCLUSIONS: The cytotoxicity to endothelial cells of the inner ear by antiendothelial cell antibody-positive sera might play a role in causing the stria vascularis damage in immune-mediated sudden sensorineural deafness. The appearance of antiendothelial cell antibody is related to the poor outcome of hearing loss, and its detection could be helpful in the selection of particular patients with sensorineural hearing loss for specific immunosuppressive treatments.     

Usefulness of high doses of glucocorticoids and hyperbaric oxygen therapy in sudden sensorineural hearing loss treatment.

OBJECTIVE: We investigated the effect of pharmacologic (steroids, vasodilators, vitamins, and Betaserc) and hyperbaric oxygen therapy on patients with sudden sensorineural hearing loss. METHODS: The pharmacologic arm of the study consisted of 52 patients with defined sudden sensorineural hearing loss treated simultaneously in the ENT Department and National Center for Hyperbaric Medicine of the Medical University of Gdansk, Poland, from 1997 to 2000 (Group A). The hyperbaric oxygen therapy consisted of exposure to 100% oxygen at a pressure of 250 kPa for a total of 60 minutes in a multiplace hyperbaric chamber. The control group included 81 patients with defined sudden sensorineural hearing loss treated in the ENT Department, Medical University of Gdansk, from 1980 to 1996 (Group B). Both groups were comparable regarding the age of the patients, season of hearing loss occurrence, tinnitus and vestibular symptom frequency, delay before therapy, and average threshold loss before the start of treatment. The treatment results (hearing gain) were estimated using pure-tone audiometry. We retrospectively analyzed the audiograms of all patients. RESULTS: Patients from Group A (blood flow-promoting drugs, glucocorticoids in high doses, betahistine, and hyperbaric oxygen therapy) showed significantly better recovery of hearing levels compared with those from Group B (blood flow-promoting drugs and glucocorticoids in low doses) at seven frequencies (500, 1,000, 2,000, 3,000, 4,000, 6,000, and 8,000 Hz) (p < 0.05) and four groups of frequencies (pure-tone average, high-tone average, pure middle-tone average, and overall average) (p < 0.05). Percentage hearing gain in all investigated frequencies was also better in Group A versus Group B, and the differences were statistically significant (p < 0.05). CONCLUSION: We conclude that hyperbaric oxygen therapy with high doses of glucocorticoids improves the results of conventional sudden sensorineural hearing loss treatment and should be recommended. In addition, the best results are achieved if the treatment is started as early as possible.     

儿童突发性聋患者的临床特征及预后分析

目的 分析儿童突发性聋(简称突聋)患者的临床特征及预后,为该病的临床诊治提供参考.方法 回顾性分析2008年1月～2016年10月确诊并治疗的23例(25耳)儿童突聋患者的临床资料,对所有患者的年龄、性别、耳别、就诊时间、病毒感染史、就诊时言语频率气导纯音听阈及听阈曲线类型、是否伴有耳鸣、眩晕、耳闷及治疗效果进行统计分析,并与同期住院治疗的202例(219耳)成人突聋患者进行对比.结果 本组儿童突聋患者占同期所有突聋患者的10.2％(23/225);儿童突聋患者就诊时平均听阈(87.7±16.1 dB HL)、全聋型比例(72.0％)、眩晕伴发率(52.2％)及病毒感染率(17.4％)均高于成人(分别为72.5±24.7 dB HL、44.7％、29.2％、3.5％),差异均有统计学意义(均为P＜0.05).治疗后儿童突聋患者与成人患者的总有效率分别为52.0％、46.6％,痊愈率分别为4.0％、14.2％,差异均无统计学意义(P＞0.05).结论 本组儿童突聋患者就诊时听力损失较重且常伴有耳鸣及眩晕,其听阈曲线以全聋型为主;疗效与成人突聋患者相当.