纤维蛋白原水平与突发性聋发病的关联性研究

目的:研究纤维蛋白原水平与突发性聋(SSHL)发病之间的关系.方法:选择50例(55耳)诊断明确、发病在7 d以内的SSHL患者(SSHL组)为研究对象,另选择50例在性别和年龄上与SSHL组患者匹配并相同的听力正常人作为对照组,分别对其血液流变学、血生化、血常规和凝血功能进行检测.结果:SSHL组纤维蛋白原水平、全血低切还原黏度、全血高切还原黏度、血浆黏度明显高于对照组,差异均有统计学意义(均P＜0.05);血浆凝血酶原时间、活化部分凝血活酶时间明显短于对照组,差异也均有统计学意义(均P＜0.05);而血生化、全血细胞计数、血小板黏附率两组比较差异无统计学意义(P＞0.05).结论:血浆纤维蛋白原水平升高可能是SSHL血管性病因中的主要因素,其发病原因可能是血浆纤维蛋白原水平提高导致血液流变学改变,血黏度增加,形成血液高凝状态或血栓形成状态,导致内耳血管微血栓,损伤耳蜗微循环.

Relationship between fibrinogen level and pathogenesis of sudden sensorineural hearing loss

Objective:To study the relationship between fibrinogen level and pathogenesis of sudden sensorineural hearing loss(SSHL).Method:Fifty patients(55 ears) with SSHL within 7 days of the onset were studied:a control group was consist of 50 normal-hearing people who were individually matched on a pairwise basis according to the same gender and age.Both the patients and the normal people were tested for the parameters of hemorheology,blood biochemistry,whole blood cell count and clotting function.Result:Fibrinogen level and plasma viscosity in patients with SSHL were significantly higher than that in control subjects.Prothombin time and activated partial thromboplastic time were significantly less in the patients group than that in the control group(P<0.05).There were statistical difference.The parameters of blood biochemistry,whole blood cell count and platelet adhesion test of two groups had no significant difference(P>0.05).Conclusion:Elevated plasma fibrinogen may be a major pathogenesis of SSHL.An increase in plasma fibrinogen level may lead to elevated plasma viscosity.All these may promote a prothrombic or hypercoagulable state and impair blood perfusion of cochlea.