摘要
目的:探讨血浆纤维蛋白原水平与不同类型突发性聋(突聋)的相关性。方法:选择225例诊断明确的突聋患者,纳入标准为年龄18~70周岁,病程<2周,未经任何相关医疗处理的突聋患者(突聋组)。按照听力曲线分为低频下降型、高频下降型、平坦下降型和全聋型4种类型;另选择229例在同一时期听力正常且无炎症性疾病的住院患者为正常对照组。分别采集血浆纤维蛋白原检查,比较2组的检查指标,行回顾性队列分析。结果:突聋组血浆纤维蛋白原均值为(2.98±0.59)g/L,明显高于对照组(2.66±0.36)g/L,差异有统计学意义(P<0.001);根据听力分型:低频下降型55例(24.44%),高频下降型36例(16.00%),平坦下降型43例(19.11%),全聋型91例(40.44%),治疗前各型血浆纤维蛋白原均值分别为(2.75±0.46)g/L,(3.16±0.61)g/L,(3.02±0.63)g/L,(3.03±0.63)g/L。不同听力类型的纤维蛋白原水平与对照组进行比较,其中低频下降型组与对照组比较差异无统计学意义(P=0.286);高频下降型组、平坦下降型组、全聋型组纤维蛋白原水平显著高于对照组,差异有统计学意义(P<0.001)。结论:低频下降型突聋发病与纤维蛋白原水平的高低无明显相关性,高频下降型、平坦下降型、全聋型突聋的发生均与发病时高纤维蛋白原水平有关。根据不同听力曲线对突聋进行分型,对于分析突聋发生的可能病因及选择不同的治疗方案有重要意义。
Objective:To investigate the correlation between plasma fibrinogen level and the incidence of sudden hearing loss.Method:A total of 225 patients(age ranging from 18 to 70 years)with sudden sensorineural hearing loss(SSNHL)were selected.The disease onset was within 2 weeks.No patient received previous medical intervention.Depending on the types of auditory threshold curve,SSNHL was divided into low frequency descending type,high frequency descending type,flat desending type and total deafness type.Two hundred and twentynine cases with normal hearing and no inflammatory diseases in the same period was selected as control group.Fibrinogen level and Blood Routine Indexes were detected for the purpose of retrospective cohort study.Result:The levels of fibrinogen in SSNHL group(2.98±0.59)g/L were significantly higher than that in control group(2.66±0.36)g/L(P<0.001).According to the types of auditory threshold curve,SSNHL groups were divided into group A(55 cases,24.44%),Group B(36 cases,16.00%),Group C(43 cases,19.11%)and Group D(91 cases,40.44%).The average fibrinogen levels before treatment were at(2.75±0.46)g/L,(3.16±0.61)g/L,(3.02±0.63)g/L and(3.03±0.63)g/L respectively.There was no significant difference in fibrinogen level(P=0.286)between group A and the control group.Fibrinogen levels of group B,group C and group D were significantly elevated compared to control group(P<0.001).Conclusion:The level of fibrinogen is not significantly correlated with development of sudden deafness of low frequency descending type.The incidence of high frequency descending type,flat descending type and profound deafness type are all correlated with the level of high fibrinogen at the onset of sudden deafness.The classification of sudden deafness based on audiogram curves could be of great significance for analysis of possible causes and selection of treatment options.
引文
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