Effect of Comorbid Diabetes and Hypercholesterolemia on the Prognosis of Idiopathic Sudden Sensorineural Hearing Loss
Effect of Comorbid Diabetes and Hypercholesterolemia on the Prognosis of Idiopathic Sudden Sensorineural Hearing Loss
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DOI：
10.1002/lary.25333
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发表时间：
2016-01-01
期刊：
影响因子：
2.6
通讯作者：
Lin, Yung-Song
中科院分区：
文献类型：
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作者：
Lin, Chang-Fu;Lee, Kuan-Ji;Lin, Yung-Song
目的：我们验证了合并症会显著影响突发性感音神经性听力损失（ISSNHL）预后的假设。研究设计：回顾性队列研究。方法：回顾性分析2003年1月至2013年12月在某三级转诊中心接受类固醇强的松龙治疗的新诊断的ISSNHL患者的记录。使用纯音平均（PTA）和单词识别评分（WRS）评估治疗前和治疗后的听力水平。糖尿病、高血压、冠状动脉疾病、高胆固醇血症、脑血管疾病、慢性肾病和贫血的合并症被确定。我们检查了这些合并症对ISSNHL治疗2个月后预后的影响。结果：经性别、年龄、预处理听力、治疗延迟时间和所有合并症校正后的回归分析显示，与糖尿病患者相比，无糖尿病患者PTA出现重大改善的概率显著更高(单因素优势比[OR]， 1.90； 95%可信区间（CI）， 1.25-2.90；多变量OR为1.69；95% ci, 1.03-2.77)。与高胆固醇血症患者相比，无高胆固醇血症患者PTA的重度（>= 90%）和中度（PTA改善50%-89%，但仍有> 10 dB的听力损失）改善显著高于高胆固醇血症患者（单因素OR， 1.78; 95% CI, 1.13-2.80；多因素OR， 1.70; 95% CI, 1.02-2.84）。然而，这些合并症的治疗后WRS的主要（bb0 - 90%）、中度（50%-89%）和轻微（< 50%）改善的分布没有显著差异。结论：合并症糖尿病或高胆固醇血症可能表明ISSNHL患者PTA主要或中度改善的可能性较小。
Objectives: We tested the hypothesis that comorbid diseases significantly affect the prognosis of sudden sensorineural hearing loss (ISSNHL).Study Design: A retrospective cohort study.Methods: The records of patients newly diagnosed with ISSNHL and treated with steroid prednisolone in a tertiary referral center between January 2003 and December 2013 were retrospectively reviewed. Pretreatment and posttreatment hearing levels were evaluated using pure-tone average (PTA) and word recognition score (WRS). The comorbidities of diabetes, hypertension, coronary artery disease, hypercholesterolemia, cerebrovascular disease, chronic kidney disease, and anemia were identified. We examined the effects of these comorbid diseases on the prognosis of ISSNHL 2 months posttreatment.Results: Regression analyses adjusted for gender, age, pretreatment hearing, treatment delay time, and all the comorbidities showed that the probability of major improvement in the PTA was significantly higher in patients without diabetes compared to those with diabetes (univariate odds ratio [OR], 1.90; 95% confidence interval (CI), 1.25-2.90; multivariate OR, 1.69; 95% CI, 1.03-2.77). Major (>= 90%) and moderate (50%-89% improvement of the PTA, but with a remaining hearing loss of > 10 dB) improvement in the PTA was significantly higher in patients without hypercholesterolemia compared to those with hypercholesterolemia (univariate OR, 1.78; 95% CI, 1.13-2.80; multivariate OR, 1.70; 95% CI, 1.02-2.84). There was, however, no significant difference in the distribution of major (> 90%), moderate (50%-89%), and minor (< 50%) improvement in the posttreatment WRS for these comorbid diseases.Conclusions: Comorbid diabetes or hypercholesterolemia may indicate a smaller probability of major or moderate PTA improvement for patients with ISSNHL.