非感染性迷路炎双侧受累的相关因素：一项病例对照研究。

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中文摘要

背景： 非感染性迷路炎（NIL）是一种内耳炎症性疾病，以耳蜗和前庭症状为特征，并伴有延迟FLAIR MRI上血-迷路屏障的损害。尽管该病最初可能表现为单侧，但部分患者随后会发展为双侧病变，这可能导致更严重的功能障碍。识别与双侧化（即从单侧受累进展为双侧受累）相关的因素在临床上仍然十分重要。
方法： 我们在一个三级转诊中心开展了一项回顾性病例对照研究，以识别与NIL双侧受累相关的因素。纳入2018年至2025年间诊断为NIL的50例患者：25例为双侧NIL（BNIL），25例为单侧NIL（UNIL）。从病历中收集临床、听力学、前庭及生物学数据。采用logistic回归分析以识别与双侧化相关的因素。
结果： 与UNIL患者相比，BNIL患者显著更年轻（42.4 ± 10.9岁 vs. 54.8 ± 11.6岁，p = 0.0003），且女性更为常见（60% vs. 24%，OR = 4.75，p = 0.010）。BNIL患者中系统性疾病更为常见（36% vs. 4.0%，OR = 13.50，p = 0.011）。在多变量分析中，较年轻年龄、女性性别以及存在系统性疾病与双侧受累独立相关。
结论： 较年轻年龄、女性以及系统性疾病与NIL的双侧化相关。这些发现可能有助于识别需要更密切临床监测的亚组。然而，鉴于回顾性病例对照设计、单中心小样本、转诊偏倚以及数据稀疏（尤其是系统性疾病方面），这些结果应被解释为探索性关联和产生假设，而非可直接用于临床风险评分的确定性预后预测因素。

英文摘要

BACKGROUND: Non-infectious labyrinthitis (NIL) is an inflammatory disorder of the inner ear characterized by cochlear and vestibular symptoms associated with impairment of the blood-labyrinth barrier on delayed FLAIR MRI. Although the condition may initially present unilaterally, some patients subsequently develop bilateral disease, which can lead to greater functional disability. Identifying factors associated with bilateralization (i.e., progression from unilateral to bilateral involvement) remains clinically important.
METHODS: We conducted a retrospective case-control study in a tertiary referral center to identify factors associated with bilateral involvement in NIL. Fifty patients diagnosed with NIL between 2018 and 2025 were included: 25 with bilateral NIL (BNIL) and 25 with unilateral NIL (UNIL). Clinical, audiometric, vestibular, and biological data were collected from medical records. Logistic regression analyses were performed to identify factors associated with bilateralization.
RESULTS: Compared with UNIL patients, BNIL patients were significantly younger (42.4 ± 10.9 vs. 54.8 ± 11.6 years, p = 0.0003) and more frequently female (60% vs. 24%, OR = 4.75, p = 0.010). Systemic disease was more frequent in BNIL patients (36% vs. 4.0%, OR = 13.50, p = 0.011). In multivariate analysis, younger age, female gender, and the presence of systemic disease were independently associated with bilateral involvement.
CONCLUSIONS: Younger age, being female, and systemic disease are associated with bilateralization in NIL. These findings may help identify subgroups who warrant closer clinical monitoring. However, given the retrospective case-control design, small single-center sample, referral bias, and sparse data (particularly for systemic disease), these results should be interpreted as exploratory associations and hypothesis-generating rather than definitive prognostic predictors ready for clinical risk scoring.