梅尼埃病中内淋巴积水与听力损失的年龄相关交互作用
Age-Related Interaction of Endolymphatic Hydrops and Hearing Loss in Meniere's Disease.
文献信息
| PMID | 42782051 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jiaying Pan |
| 作者单位 | Department of Otorhinolaryngology, ENT Institute and Eye & ENT Hospital, Fudan University, Shanghai, China. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 探讨经钆增强内耳磁共振成像（MRI）确诊的梅尼埃病（MD）患者中年龄、内淋巴积水（EH）与听阈之间的关联，并探究EH对听力损失的年龄依赖性效应。
研究设计： 回顾性研究。
地点： 三级医疗中心。
方法： 我们纳入了2020年1月至2025年4月期间诊断为MD的455例患者（910耳）。在钆增强内耳MRI上采用既定的前庭和耳蜗积水分类系统对EH进行分级。通过纯音测听获得听阈（0.125-8 kHz）。采用多变量有序logistic回归评估年龄与EH分级之间的关联。应用具有Gamma分布和对数链接的广义相加模型，评估年龄与EH严重程度在低频、中频和高频范围及四频率平均值之间的非线性交互作用。
结果： 年龄分布在不同EH侧别、部位或分级之间无显著差异，且年龄与EH严重程度无独立关联。EH分级和年龄均与听阈显著相关（P < .05）。在单侧和双侧MD中，较高的EH分级始终与更严重的听力损失相关。相比之下，年龄的影响在较低EH分级（I-III）最为明显，而在较高分级（IV-V）中减弱。
结论： 在MD患者中，年龄与EH的存在或严重程度无显著关联。较高的EH分级始终与更严重的听力损失相关。同时，年龄的效应在轻至中度EH分级中最为明显，而在晚期阶段减弱。
英文摘要
OBJECTIVE: To examine the associations among age, endolymphatic hydrops (EH), and hearing thresholds in patients with Meniere's disease (MD) confirmed by gadolinium-enhanced inner ear magnetic resonance imaging (MRI), and to explore age-dependent effects of EH on hearing loss.
STUDY DESIGN: Retrospective study.
SETTING: Tertiary medical center.
METHODS: We included 455 patients (910 ears) diagnosed with MD between January 2020 and April 2025. EH was graded using established vestibular and cochlear hydrops classification systems on Gd-enhanced inner ear MRI. Hearing thresholds (0.125-8 kHz) were obtained by pure-tone audiometry. Multivariable ordinal logistic regression assessed associations between age and EH grade. Generalized additive models with a Gamma distribution and log link were applied to evaluate nonlinear interactions between age and EH severity across low-, mid-, and high-frequency ranges and four-frequency averages.
RESULTS: Age distribution did not differ significantly across EH laterality, site, or grade, and age was not independently associated with EH severity. Both EH grade and age were significantly associated with hearing thresholds (P < .05). Higher EH grades were consistently correlated with greater hearing loss in both unilateral and bilateral MD. In contrast, the influence of age was most evident at lower EH grades (I-III) and diminished in higher grades (IV-V).
CONCLUSION: Age was not significantly associated with the presence or severity of EH in patients with MD. Higher EH grades were consistently associated with greater hearing loss. At the same time, the effect of age was most evident in mild-to-moderate EH grades and diminished in advanced stages.