Lin Chang-Fu, Lee Kuan-Ji, Yu Shiou-Shyan, Lin Yung-Song
Department of Otolaryngology, Chi Mei Medical Center, Yongkang District, Tainan City.
Center of General Education, Southern Taiwan University of Science and Technology, Tainan.
Laryngoscope. 2016 Jan;126(1):142-9. doi: 10.1002/lary.25333. Epub 2015 May 6.
We tested the hypothesis that comorbid diseases significantly affect the prognosis of sudden sensorineural hearing loss (ISSNHL).
A retrospective cohort study.
The records of patients newly diagnosed with ISSNHL and treated with steroid prednisolone in a tertiary referral center between January 2003 and December 2013 were retrospectively reviewed. Pretreatment and posttreatment hearing levels were evaluated using pure-tone average (PTA) and word recognition score (WRS). The comorbidities of diabetes, hypertension, coronary artery disease, hypercholesterolemia, cerebrovascular disease, chronic kidney disease, and anemia were identified. We examined the effects of these comorbid diseases on the prognosis of ISSNHL 2 months posttreatment.
Regression analyses adjusted for gender, age, pretreatment hearing, treatment delay time, and all the comorbidities showed that the probability of major improvement in the PTA was significantly higher in patients without diabetes compared to those with diabetes (univariate odds ratio [OR], 1.90; 95% confidence interval (CI), 1.25-2.90; multivariate OR, 1.69; 95% CI, 1.03-2.77). Major (≥ 90%) and moderate (50%-89% improvement of the PTA, but with a remaining hearing loss of > 10 dB) improvement in the PTA was significantly higher in patients without hypercholesterolemia compared to those with hypercholesterolemia (univariate OR, 1.78; 95% CI, 1.13-2.80; multivariate OR, 1.70; 95% CI, 1.02-2.84). There was, however, no significant difference in the distribution of major (≥ 90%), moderate (50%-89%), and minor (< 50%) improvement in the posttreatment WRS for these comorbid diseases.
Comorbid diabetes or hypercholesterolemia may indicate a smaller probability of major or moderate PTA improvement for patients with ISSNHL.
我们检验了合并疾病会显著影响突发性感音神经性听力损失（ISSNHL）预后这一假设。
一项回顾性队列研究。
回顾性分析2003年1月至2013年12月期间在一家三级转诊中心新诊断为ISSNHL并接受类固醇泼尼松龙治疗的患者记录。使用纯音平均听阈（PTA）和言语识别得分（WRS）评估治疗前和治疗后的听力水平。确定糖尿病、高血压、冠状动脉疾病、高胆固醇血症、脑血管疾病、慢性肾病和贫血等合并疾病。我们研究了这些合并疾病对治疗后2个月ISSNHL预后的影响。
在对性别、年龄、治疗前听力、治疗延迟时间和所有合并疾病进行校正的回归分析中，与糖尿病患者相比，非糖尿病患者PTA显著改善的概率更高（单因素优势比[OR]，1.90；95%置信区间[CI]，1.25 - 2.90；多因素OR，1.69；95% CI，1.03 - 2.77）。与高胆固醇血症患者相比，非高胆固醇血症患者PTA的显著（≥90%）和中度（PTA改善50% - 89%，但仍有>10 dB的听力损失）改善显著更高（单因素OR，1.78；95% CI，1.13 - 2.80；多因素OR，1.70；95% CI，1.02 - 2.84）。然而，对于这些合并疾病，治疗后WRS的显著（≥90%）、中度（50% - 89%）和轻度（<50%）改善分布没有显著差异。
合并糖尿病或高胆固醇血症可能表明ISSNHL患者PTA显著或中度改善的可能性较小。
