突发性聋伴眩晕患者血管损伤因素相关检查结果的分析

目的 总结突发性聋伴眩晕四种听力类型患者的临床特点,分析与血管损伤因素相关检查的临床价值及意义,了解血管因素在突发性聋伴眩晕发病机制中的作用.方法 收集我院2015年10月至2017年4月住院治疗的突发性聋伴眩晕病例,按听力曲线类型分成低频下降型、高频下降型、全频下降型、全聋型4组,分析其颅多普勒(TCD)、颈部血管彩色多普勒超声、MRI检查结果异常的分布情况和血浆同型半胱氨酸(HCY)水平.结果 突发性聋伴眩晕病例中全聋型占35.7％、高频听力下降型24.5％,低频听力下降型20.4％,平坦下降型19.4％.血管相关检查结果显示,血浆同型半胱氨酸异常检出率为83.7％,MRI为67.3％,颈部彩超为52.0％,TCD为17.3％.低频下降型患者血管相关检查异常率明显低于其他类型患者,差异有统计学意义(P＜0.05).结论 突发性聋伴眩晕病人中,低频下降型血管因素影响较小.同型半胱氨酸和MRI检查是突发性聋伴眩晕病人血管损伤性因素的敏感指标.

Analysis of related factors for vascular damage in sudden hearing loss with vertigo

Objective To investigate the clinical characteristics of cases with sudden hearing loss with vertigo,the value of conventional vascular function examinations for four types of sudden hearing loss,and the roles of vascular factors in pathophysiology of sudden hearing loss with vertigo.Methods Patients diagnosed as sudden hearing loss with vertigo and treated in our hospital between October 2015 and April 2017 were divided into four groups based on pure tone audiometry:low frequency hearing loss group,high frequency hearing loss group,fiat hearing loss group and completed deafness group.Clinical characteristics of cases were analyzed and the results of homocysteine (HCY),transcranial Doppler (TCD),carotid duplex ultrasound and craniocerebral MRI were compared.Results Completed deafness group,high frequency hearing loss group,low frequency hearing loss group and flat hearing loss group accounted for 35.7％,24.5％,20.4％ and 19.4％ of all cases.Among vascular function examinations,HCY was the most frequently f abnormal test (83.7％),followed by craniocerebral MRI (67.3％),carotid ultrasound (52.0％) and TCD (17.3％).The rate of abnormal vascular function examination results in low frequency hearing loss group was significantly lower than other groups (P ＜0.05).Conclusion Vascular factors have less impact on the development of sudden hearing loss with vertigo and it is not so frequently associated with hearing loss.HCY and MRI are sensitive indicators for vascular damage in patients suffering from sudden hearing loss with vertigo.