Department of Otolaryngology, Taipei City Hospital, Taipei, Taiwan.
Department of Teaching and Research, Taipei City Hospital, Taipei, Taiwan3Department of Public Health, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
JAMA Otolaryngol Head Neck Surg. 2016 Jul 1;142(7):672-5. doi: 10.1001/jamaoto.2016.0845.
Little is known about the association between sudden sensorineural hearing loss (SSNHL) and vertebrobasilar insufficiency (VBI).
To explore the association between SSNHL and VBI.
DESIGN, SETTING, AND PARTICIPANTS: This investigation was a population-based, case-control study. Patients from January 1, 2000, to December 31, 2011, were retrospectively identified from the Taiwan National Health Insurance Research Database, which includes claims data on a random sample of 1 million people.
Using propensity score matching on age and sex, patients were stratified at a 1:4 ratio into a study group comprising 5304 patients with a diagnosis of SSNHL and a control group comprising 21 216 patients. Those with a diagnosis of VBI before the index date (the date each patient was diagnosed as having SSNHL) in both groups were then identified. A conditional logistic regression model was used to estimate the adjusted odds ratios (ORs) and 95% CIs as a measure of the association between SSNHL and VBI.
The study cohort comprised 26 520 patients. Their mean (SD) age was 51.3 (17.2) years, and 47.1% (12 500 of 26 520) were female. Vertebrobasilar insufficiency was diagnosed before the index date in 0.5% (26 of 5304) of patients with SSNHL and in 0.2% (38 of 21 216) of controls without SSNHL. After adjusting for comorbid medical disorders, patients with SSNHL were more likely than controls to have had VBI (OR, 1.76; 95% CI, 1.02-3.04). There were no significant differences in the prevalence of VBI among male patients with SSNHL vs male controls (OR, 1.72; 95% CI, 0.87-3.40) or among female patients with SSNHL vs female controls (OR, 1.86; 95% CI, 0.76-4.59).
Patients with VBI appear to be at increased risk of developing SSNHL. Further research is needed to investigate the association among the severity of VBI, the risk of SSNHL, and the pattern of the audiometric curve.
突发性聋（SSNHL）与椎基底动脉供血不足（VBI）之间的关联鲜为人知。
探究 SSNHL 与 VBI 之间的关联。
设计、环境和参与者：本研究为基于人群的病例对照研究。2000 年 1 月 1 日至 2011 年 12 月 31 日，通过台湾全民健康保险研究数据库回顾性地确定了患者，该数据库包含对随机抽取的 100 万人的索赔数据。
根据年龄和性别进行倾向评分匹配，按 1:4 的比例将患者分层为研究组（5304 例确诊为 SSNHL 的患者）和对照组（21216 例患者）。然后，在两组中均确定在指数日期（每位患者被诊断为患有 SSNHL 的日期）之前被诊断为 VBI 的患者。使用条件逻辑回归模型来估计调整后的优势比（OR）和 95%置信区间（CI），以衡量 SSNHL 与 VBI 之间的关联。
研究队列共包括 26520 例患者。他们的平均（SD）年龄为 51.3（17.2）岁，47.1%（12500 例/26520 例）为女性。在 SSNHL 患者中，有 0.5%（26 例/5304 例）和对照组中无 SSNHL 的患者中有 0.2%（38 例/21216 例）在指数日期之前被诊断为 VBI。在调整合并的医疗疾病后，与对照组相比，患有 SSNHL 的患者发生 VBI 的可能性更高（OR，1.76；95%CI，1.02-3.04）。在 SSNHL 男性患者与男性对照组（OR，1.72；95%CI，0.87-3.40）或 SSNHL 女性患者与女性对照组（OR，1.86；95%CI，0.76-4.59）之间，VBI 的患病率无显著差异。
患有 VBI 的患者似乎发生 SSNHL 的风险增加。需要进一步的研究来探讨 VBI 的严重程度、SSNHL 的风险和听力曲线的模式之间的关联。
