急性低频感音神经性听力损失的特征及预后评估：546例回顾性分析

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中文摘要

背景/目的： 近年来急性低频听力损失的发病率逐渐上升。然而，其具体病因和病理生理机制在很大程度上仍不清楚。因此，本研究旨在探讨急性低频感音神经性听力损失的预后因素。
患者与方法： 根据治疗后纯音听阈将患者分为完全恢复、显著恢复、轻度恢复或无变化。我们分析了预后与年龄、性别、患侧、发病机制、基础疾病、发病天数、眩晕、听力损失程度、前庭功能、耳蜗电图结果以及钆增强内耳MRI之间的相关性。相关性分析采用单因素和多因素logistic回归完成。p值<0.05被认为具有统计学意义。
结果： 共纳入546例急性低频感音神经性听力损失患者。单因素分析显示，各组在年龄、发病天数、听力损失程度、钆增强内耳磁共振成像上的耳蜗积水以及异常耳蜗电图方面存在显著差异（均p<0.001），在冷热试验和头脉冲试验结果方面也存在显著差异（均p<0.05）。多因素logistic回归分析显示，年龄、重度听力损失和异常耳蜗电图结果与预后显著相关。年龄（p<0.001）和耳蜗电图结果（p<0.05）与完全恢复显著相关；听力损失程度与明显疗效显著相关（p<0.01）。
结论： 年龄增长、异常耳蜗电图和听力损失程度与ALHL不良预后独立相关。随着进一步研究，这些结果可能推动改进临床诊断指南的制定，最终影响患者结局。

英文摘要

BACKGROUND/OBJECTIVES: The incidence of acute low-frequency hearing loss has gradually increased in recent years. However, its specific etiology and pathophysiology remain largely unclear. Therefore, the aim of this study was to investigate the prognostic factors of acute low-frequency sensorineural hearing loss.
PATIENTS AND METHODS: Patients were grouped based on post-treatment pure-tone hearing thresholds: complete, marked, and slight recovery, or no change. We analyzed correlations between prognosis and age, sex, affected side, pathogenesis, underlying diseases, onset days, dizziness, degree of hearing loss, vestibular function, electrocochleography results, and gadolinium-enhanced inner ear MRI. Correlational analyses were completed using univariate and multivariate logistic regression. A p-value < 0.05 was considered statistically significant.
RESULTS: Overall 546 patients with acute low-frequency sensorineural hearing loss were included. Univariate analysis revealed significant differences among groups regarding age, onset days, degree of hearing loss, cochlear hydrops on gadolinium-enhanced inner ear magnetic resonance imaging, and abnormal electrocochleography (all p < 0.001), and in caloric and head impulse test results (all p < 0.05). Multivariate logistic regression analysis showed that age, severe hearing loss, and abnormal electrocochleography results were significantly associated with prognosis. Age (p < 0.001) and electrocochleography results (p < 0.05) were significantly associated with complete recovery; degree of hearing loss was significantly associated with obvious effects (p < 0.01).
CONCLUSIONS: Advancing age, abnormal electrocochleography, and degree of hearing loss were independently associated with poor prognosis of ALHL . With further study, these results could drive the development of improved clinical diagnostic guidelines to ultimately impact patient outcomes.