代谢综合征对突发性聋患者听力预后的影响

目的探讨代谢综合征(metabolic syndrome, MS)对突发性聋(突聋)患者听力预后的影响。方法以178例突聋患者为研究对象,根据是否合并MS分为MS组(70例)和非MS组(108例),通过单因素及多因素分析分析性别、年龄、病程、初诊听阈值、高血压病、糖尿病、体重指数(BMI)、高脂血症对突聋患者听力预后的影响。结果 MS组患者的BMI、收缩压、舒张压、甘油三酯、空腹血糖水平高于非MS组,而高密度脂蛋白水平低于非MS组,差异均有统计学意义(均为P<0.05);治疗后,MS组中痊愈率和显效率分别为7.14%和8.57%,低于非MS组(分别为20.37%和29.63%),MS组中的无效率为51.43%,高于非MS组(25.00%)(P<0.05);多因素分析结果显示MS、糖尿病和高脂血症为突聋患者听力预后的不利因素,初诊听阈值越高、病程越长,听力预后越差。结论合并MS的突聋患者听力预后差;就诊时听力损失程度轻、病程短及无伴发糖尿病和高脂血症的患者预后较好。

The Effects of Metabolic Syndrome on the Prognosis of Sudden Sensorineural Hearing Loss

Objective To investigate the effects of metabolic syndrome(MS) on the prognosis of sudden sensorineural hearing loss(SSNHL).Methods A total of 178 patients diagnosed with SSNHL in our department between January 2013 and January 2018 were enrolled and divided into MS group(70 patients) and non-MS group(108 patients). The clinical characteristics and prognosis were compared between the two groups. Univariate and multivariate logistic analysis were performed to identify prognostic factors of SSNHL, including gender, age, treatment delay time, lower initial hearing threshold, hypertension, diabetes mellitus, hyperlipidemia and obesity.Results In the MS group, the BMI, systolic pressure, diastolic pressure, TG, and fasting plasma glucose level were higher than those of in the non-MS group, while the HDL-C level was lower than those of in non-MS group(P<0.05). In the MS group, the complete recovery rate and marked recovery rate were 7.14% and 8.57%, respectively, lower than those of in the non-MS group(20.37% and 29.63%, P<0.05), while the rate of non-recovery was higher(51.43% VS 25.00%,P<0.05). According to multivariate analysis, MS, diabetes mellitus and hyperlipidemia were significantly correlated with the poor prognosis;later onset of treatment and higher initial hearing threshold were associated with a poor prognosis.Conclusion The presence of MS could have a negative impact on the prognosis of SSNHL. Lower initial hearing threshold, earlier onset of treatment and absence of diabetes mellitus and hyperlipidemia were associated with favorable hearing recovery.