拉姆齐-亨特综合征与贝尔麻痹患者的预后比较
Comparative prognosis in patients with Ramsay-Hunt syndrome and Bell's palsy.
作者信息
Kim Seok Hyun, Jung Junyang, Jung Su Young, Dong Sung Hwa, Byun Jae Yong, Park Moon Suh, Kim Sang Hoon, Yeo Seung Geun
机构信息
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Republic of Korea.
Department of Anatomy and Neurobiology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
出版信息
Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1011-1016. doi: 10.1007/s00405-019-05300-3. Epub 2019 Feb 1.
PURPOSE
Patients with Ramsay-Hunt syndrome have a poorer prognosis than patients with Bell's palsy. Factors of metabolic syndrome affecting prognosis were therefore compared between patients with Ramsay-Hunt syndrome and those with Bell's palsy.
METHODS
This retrospective study included 106 with Ramsay-Hunt syndrome and 182 with Bell's palsy. Age, sex, body mass index, blood pressure, blood test results, and ENoG results, stratified by House-Brackmann grade, were compared in patients with Ramsay-Hunt syndrome and Bell's palsy. Both groups of patients were treated with steroids and the antiviral agent famciclovir.
RESULTS
Age, sex, body mass index, dyslipidemia, triglyceride, diabetes, hypertension, and onset of palsy did not differ in patients with Ramsay-Hunt syndrome and Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and DM were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy and were also lower in low-weight, normal weight, and overweight patients with Ramsay-Hunt syndrome than with Bell's palsy. Rates of favorable recovery in patients with severe facial palsy and normal HDL, as well as in patients with severe facial palsy and < 10% ENoG, were lower in patients with Ramsay-Hunt syndrome than with Bell's palsy.
CONCLUSIONS
Among patients with severe facial palsy, along with diabetes and < 10% ENoG, unfavorable recovery rates were significantly higher in those with Ramsay-Hunt syndrome than with Bell's palsy.
目的
拉姆齐-亨特综合征患者的预后比贝尔麻痹患者差。因此，对拉姆齐-亨特综合征患者和贝尔麻痹患者中影响预后的代谢综合征因素进行了比较。
方法
这项回顾性研究纳入了106例拉姆齐-亨特综合征患者和182例贝尔麻痹患者。对拉姆齐-亨特综合征患者和贝尔麻痹患者的年龄、性别、体重指数、血压、血液检查结果以及按House-Brackmann分级分层的神经电图（ENoG）结果进行了比较。两组患者均接受了类固醇和抗病毒药物泛昔洛韦治疗。
结果
拉姆齐-亨特综合征患者和贝尔麻痹患者在年龄、性别、体重指数、血脂异常、甘油三酯、糖尿病、高血压以及面瘫发作方面没有差异。重度面瘫和糖尿病患者中，拉姆齐-亨特综合征患者的良好恢复率低于贝尔麻痹患者，且拉姆齐-亨特综合征的低体重、正常体重和超重患者的良好恢复率也低于贝尔麻痹患者。重度面瘫且高密度脂蛋白（HDL）正常的患者以及重度面瘫且ENoG＜10%的患者中，拉姆齐-亨特综合征患者的良好恢复率低于贝尔麻痹患者。
结论
在重度面瘫患者中，除糖尿病和ENoG＜10%外，拉姆齐-亨特综合征患者的不良恢复率显著高于贝尔麻痹患者。
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