突发性感音神经性耳聋患者睡眠状况与其预后的相关性研究

摘要

Objective To determinate the relationship between sleep status and prognosis of patients with sud-den sensorineural hearing loss (SSNHL),providing the scientific basis for clinical care.Methods Ninety -eight pa-tients with SSNHL of 3 to 30 days duration were enrolled in the department of internal medicine,the General Hospital of PLA from September 2014 to April 2015.The sleep status and subjective symptoms (tinnitus and ear stuffiness)were collected by Pittsburgh Sleep Quality Index (PSQI)scale and self-designed general information questionnaire.The prog-nosis of patients through collected hearing level from medical records was evaluated comprehensively.Results There was a positive correlation between the sleep status and improvement of hearing level in patients with SSNHL (P =0.001).The sleep status had no relativity with improvement of tinnitus in patients with SSNHL(P =0.441).The total effective rate of tinnitus in patients with PSQI <4 was 87.5%,but the rate of tinnitus in patients with PSQI >12 was 33.3%.The result indicating that the total effective rate of tinnitus in patients without sleep disorders was higher than those with sleep disorders.The total effective rate of ear stuffiness was 92.3% in patients with SSNHL.There was a posi-tive correlation between the sleep status and improvement of ear stuffiness in patients with SSNHL (P =0.000).Five patients still had ear stuffiness when discharged,four of them were PSQI >12.Conclusions The sleep status of patients with SSNHL had impacts on the treatment effect 4 weeks inside including hearing level and the improvement of subjec-tive symptoms,the good sleep has the some value in improving the prognosis.%目的：探讨突发性感音神经性耳聋（简称突聋）患者睡眠状况与其预后包括听力学和主观症状改善程度的相关关系，为临床保健指导提供科学依据。方法对98例病程3～30 d 的突聋患者通过匹兹堡睡眠质量指数（PSQI）量表和自行设计的一般情况调查表收集患者的睡眠状况和主观症状（耳鸣和耳闷堵感）改善情况，通过调查病历收集患者的听力学改善情况，从而综合评估患者的预后信息。结果突聋患者的睡眠状况与听力学改善程度存在趋势相关性（P ＝0．001），呈现正相关，不同睡眠程度与听力学改善程度存在直线关系趋势。突聋患者的睡眠状况与耳鸣改善程度不存在趋势相关性（P ＝0．441）。但 PSQI ＜4分的突聋患者耳鸣改善总有效率为87．5％，PSQI ＞12分的突聋患者耳鸣改善总有效率为33．3％，突聋患者耳闷堵感治疗总有效率92．3％，突聋患者不同睡眠状况与治疗后耳闷堵感改善情况存在趋势相关性（P ＝0．000），出院时仅5例仍有耳闷堵感，其中4例集中在 PSQI ＞12分的患者中。结论突聋患者的睡眠状况对患者发病后4周内的治疗效果包括听力学和主观症状改善程度有影响，良好睡眠状况有助改善突聋预后。