發(fā)布時(shí)間：2018-03-18 06:16

  本文選題：突發(fā)性耳聾　切入點(diǎn)：內(nèi)耳釓造影磁共振　出處：《中華耳科學(xué)雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的通過(guò)對(duì)單側(cè)突發(fā)性耳聾患者進(jìn)行純音測(cè)聽(tīng)、內(nèi)耳釓造影MRI檢查、cVEMP檢查以探討突聾患者的可能發(fā)病機(jī)制及在突聾患者中膜迷路積水與cVEMP異常的相關(guān)性。方法根據(jù)純音測(cè)聽(tīng)結(jié)果對(duì)65例單側(cè)突發(fā)性耳聾患者分為低頻組、高頻組、平坦組、全聾組,進(jìn)行內(nèi)耳釓造影MRI及cVEMP檢查,比較各個(gè)組間釓造影陽(yáng)性率和cVEMP陽(yáng)性率;按照釓造影結(jié)果分組,分別計(jì)算釓造影陽(yáng)性組、陰性組的cVEMP陽(yáng)性率。結(jié)果 65例患者中,低頻組14人,釓造影陽(yáng)性率35.7%(5/14),cVEMP陽(yáng)性率50%(7/14);高頻組11人,釓造影陽(yáng)性率0(0/11),cVEMP陽(yáng)性率9.1%(1/11);平坦組17人,釓造影陽(yáng)性率17.6%(3/17),cVEMP陽(yáng)性率35.3%(6/17);全聾組23人,釓造影陽(yáng)性率13.0%(3/23),cVEMP陽(yáng)性率43.5%(10/23);低頻組、平坦組、全聾組兩兩之間的釓造影陽(yáng)性率無(wú)明顯差異性;各個(gè)頻率兩兩之間cVEMP陽(yáng)性率未存在完全性明顯差異;釓造影陽(yáng)性共11例,cVEMP陽(yáng)性共24例。其中釓造影陽(yáng)性組中cVEMP陽(yáng)性率63.64%(7/11),釓造影陰性組中cVEMP陽(yáng)性率31.48%(17/54),二者差值具有統(tǒng)計(jì)學(xué)意義(P 0.05)。結(jié)論內(nèi)耳釓造影MRI提示突發(fā)性耳聾目前仍是病因不明的疾病,膜迷路積水是低頻型突發(fā)性聾的一種可能發(fā)病機(jī)制,而平坦型、全聾型突聾的膜迷路積水可能為內(nèi)耳損傷后出現(xiàn)的一種病理結(jié)果;cVEMP可能在不同頻率的突聾類型檢出率無(wú)明顯獨(dú)特性,在一定程度上可能可以提示突發(fā)性聾患者存在膜迷路積水情況。
[Abstract]:Objective to conduct pure tone audiometry in patients with unilateral sudden deafness. In order to explore the possible pathogenesis of sudden deafness and the correlation between hydrolabyrinth and abnormal cVEMP in patients with sudden deafness, 65 patients with unilateral sudden deafness were divided into low frequency group according to the results of pure tone audiometry. High frequency group, flat group and total deafness group were examined with MRI and cVEMP. The positive rate of gadolinium angiography and positive rate of cVEMP were compared among each group, according to the results of gadolinium angiography, the positive rate of gadolinium angiography was calculated. Results the positive rate of gadoliniography in low frequency group (14 cases) was 35.7%, and the positive rate of gadoliniography was 50 / 7 / 14%. In high frequency group (11 cases), the positive rate of gadoliniography was 0.1% / 11%. The positive rate of gadolinium angiography was 17 cases in flat group (17 cases). The positive rate of gadolinium angiography was 17.617%. The positive rate of gadolinium examination was 35.31717%; and the positive rate of gadoliniography was 35.31717% in total deafness group (23 cases), and the positive rate of gadoliniography was 0.1% / 11% (n = 11), 17 cases in flat group (n = 17). The positive rate of gadolinium angiography was 13.0% and the positive rate of cVEMP was 43.5%. There was no significant difference between low frequency group, flat group and total deafness group, and there was no significant difference in positive rate of cVEMP between two groups. The positive rate of cVEMP in gadolinium-positive group was 63.64 / 11, and the positive rate of cVEMP in gadolinium-negative group was 31.48 / 54.The difference was statistically significant (P < 0.05). Conclusion Gadoliniography MRI indicates sudden deafness. Is still a disease of unknown etiology, Membranous hydrolabyrinth is a possible pathogenesis of low-frequency sudden deafness. The hydrops of membranous labyrinth in all deafness may be a pathological result after inner ear injury. The detection rate of camp may not be distinct in different frequency of sudden deafness. To some extent, it may indicate the presence of membranous labyrinth hydrops in patients with sudden deafness.
【作者單位】： 福建醫(yī)科大學(xué)附屬第一醫(yī)院耳鼻咽喉科;福建醫(yī)科大學(xué)附屬第一醫(yī)院耳鼻咽喉科研究所;
【基金】：福建省醫(yī)學(xué)創(chuàng)新課題(2014-CX-24)資助~~
【分類號(hào)】：R764.437

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