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应用血栓弹力描记术评估突发性聋患者的凝血状态。

Coagulation States in Patients With Sudden Sensorineural Hearing Loss Evaluated by Thromboelastography.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.

Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.

出版信息

Otolaryngol Head Neck Surg. 2021 Jun;164(6):1280-1286. doi: 10.1177/0194599820965240. Epub 2020 Nov 3.

Abstract

OBJECTIVE

The state of coagulation is controversial in patients with sudden sensorineural hearing loss (SSNHL). We used thromboelastography (TEG) to explore the relationships between blood coagulation parameters and SSNHL pathogenesis and recovery.

STUDY DESIGN

Prospective study.

SETTING

Affiliated Sixth People's Hospital, Shanghai Jiao Tong University.

METHODS

A total of 104 newly diagnosed patients with SSNHL and 29 matched healthy controls were recruited. Hearing assessments, TEG, and conventional coagulation tests (CCTs) were performed, followed by standard treatments and follow-up.

RESULTS

The TEG parameters of patients with SSNHL were in the normal range, but the group exhibited a significantly prolonged kinetic time (K; = .004) and a smaller angle ( = .003) as compared with the controls. After grouping the patients with SSNHL according to audiograms and comparing them in pairs, we found that the differences were significant only when controls were compared with patients with low-frequency SSNHL (K, = .023; angle, = .04) and flat-type SSNHL (K, = .017; angle, = .014). Logistic regression analysis showed that neither TEG nor CCT parameters significantly affected hearing improvement after SSNHL treatment.

CONCLUSIONS

Although the K value and angle were significantly increased and significantly reduced, respectively, in the test group as compared with the control group, the state of coagulation in patients with SSNHL was still within the normal range. No CCT or TEG coagulation parameters (except the angle) differed significantly among patients in each group according to hearing recovery status, which suggested that the coagulation status does not determine the prognosis of patients with SSNHL.

摘要

目的

凝血状态在突发性聋患者中存在争议。我们使用血栓弹力图(TEG)来探索凝血参数与突发性聋发病机制和恢复之间的关系。

研究设计

前瞻性研究。

设置

上海交通大学附属第六人民医院。

方法

共纳入 104 例新发突发性聋患者和 29 例匹配的健康对照者。进行听力评估、TEG 和常规凝血检测(CCT),然后进行标准治疗和随访。

结果

突发性聋患者的 TEG 参数在正常范围内,但与对照组相比,患者的动力学时间(K)显著延长( =.004),角度显著减小( =.003)。根据听力图对突发性聋患者进行分组并进行配对比较后,我们发现仅当对照组与低频突发性聋患者(K, =.023;角度, =.04)和平坦型突发性聋患者(K, =.017;角度, =.014)进行比较时,差异才有统计学意义。Logistic 回归分析显示,无论是 TEG 还是 CCT 参数,在突发性聋治疗后对听力改善均无显著影响。

结论

尽管与对照组相比,试验组的 K 值显著升高,角度显著降低,但突发性聋患者的凝血状态仍在正常范围内。根据听力恢复情况,各组患者之间的 CCT 或 TEG 凝血参数(除角度外)均无显著差异,这表明凝血状态并不能决定突发性聋患者的预后。

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