| Objective: To explore the clinical characteristics,prognosis and their influencing factors,and provide the basis for the individualized prevention and treatment of non-elderly adult patients with sudden sensorineural hearing loss(SSNHL)and different blood glucose levels.Methods: 1.Clinical data.240 non-elderly adult patients with SSNHL were analyzed retrospectively in the Affiliated Hospital of Southwest Medical University from January 2018 to December 2022.The general data including blood glucose after fasting and 2 hours after a glucose challenge,blood routine,lipids,coagulation function,audiological examination before and after treatment,and other relevant data were collected.2.Cases grouping.Patients were divided into SSNHL with diabetes group(n=43)and SSNHL without diabetes group(n=197).Meanwhile,according to the quartile method,197 patients without diabetes were further divided into four groups,including Group Ⅰ(blood glucose≤ 4.50mmol/L),Ⅱ(4.50mmol/L < blood glucose ≤ 4.76mmol/L),Ⅲ(4.76mmol/L<blood glucose≤5.00mmol/L),and IV(5.00mmol/L<blood glucose≤6.10mmol/L).And 43 patients with diabetes were regarded as Group V.According to the standards of otolaryngology head and neck surgery branch of the Chinese Medical Association in 2015,patients with SSNHL were divided into low-frequency descending,high-frequency descending,flat descending,and total deafness including extremely severe deafness types by the frequency and degree of hearing loss.Moreover,there were cured,obvious effective,effective and ineffective groups according to the prognosis of SSNHL.3.Research contents.The clinical classification,degree of hearing loss,prognosis,and their influencing factors,and relations with coagulation,blood lipids,inflammatory indicators,hemoglobin and other indicators were analyzed in non-elderly adult patients with SSNHL and different blood glucose levels.Moreover,the clinical classification,degree of hearing loss and prognosis were analyzed in non-elderly adult patients of SSNHL with diabetes.4.Statistical analysis.SPSS 23.0statistical software was used for data analysis.First,Chi-square test was used to compare the clinical classification,and differences between two Groups.Second,Kruskal-Wallis test was used to compare the degree of hearing loss and prognosis.Finally,Spearman correlation analysis was used to analyze the influencing factors for clinical classification,degree of hearing loss and prognosis in nonelderly adult patients with SSNHL and different blood glucose levels.P<0.05 means statistical significance.Results: 1.Clinical classification of non-elderly adult patients with SNHL and different blood glucose levels.There were 10(19.6%),10(19.6%),12(23.5%),and 19 ears(37.3%)in Group Ⅰ,9(17.0%),9(17.0%),20(37.7%)and15 ears(28.3%)in Group Ⅱ,17(33.3%),7(13.7%),14(27.5%)and 13 ears(25.5%)in Group Ⅲ,7(13.7%),15(29.5%),9(17.6%)and 20 ears(39.2%)in Group Ⅳ,and 3(6.8%),18(40.9%),9(20.5%)and 14 ears(31.8%)in Group Ⅴrespectively for low-frequency descending,high-frequency descending,flat descending and total deafness types.There was a statistical difference in the clinical classifications(?2=26.895,P=0.008).In Group V,there were more highfrequency descending and total deafness types than in Group II(?2=9.453,P=0.024)and III(?2=15.331,P=0.002),and fewer low-frequency descending and flat descending types in Group II(?22=9.453,P=0.024)and III(?2=15.331,P=0.002).In Group Ⅳ,there were more high-frequency descending and total deafness types than in Group III(?2=9.648,P=0.022),and fewer low-frequency descending and flat descending types in Group III(?2=9.648,P=0.022).2.Analysis of the degree of hearing loss in non-elderly adult patients with SSNHL and different blood glucose levels.There were 6(11.8%),16(31.4%),9(17.6%)and 20 ears(39.2%)in Group Ⅰ,5(9.4%),14(26.4%),18(34.0%)and 16 ears(30.2%)in Group Ⅱ,13(25.4%),16(31.4%),6(11.8%)and 16 ears(31.4%)in Group Ⅲ,7(13.7%),12(23.5%),11(21.6%)and 21 ears(41.2%)in Group Ⅳ,and 7(15.9%),11(25.0%),8(18.2%)and 18 ears(40.9%)in Group Ⅴrespectively for mild hearing loss,moderate hearing loss,severe hearing loss and extremely severe hearing loss groups.There was no statistical difference in the degree of hearing loss in non-elderly adult patients with SSNHL and different blood glucose levels by Kruskal-Wallis test(H=4.276,P=0.370).3.Analysis of prognosis in non-elderly adult patients with SSNHL and different blood glucose levels.There were 29(56.9%),9(17.6%),4(7.9%)and 9 ears(17.6%)in GroupⅠ,32(60.4%),7(13.2%),5(9.4%)and 9 ears(17.0%)in Group Ⅱ,22(43.1%),13(25.5%),4(7.9%)and 12 ears(23.5%)in Group Ⅲ,27(52.9%),10(19.6%),4(7.9%)and 10 ears(19.6%)in Group Ⅳ,and 29(65.9%),4(9.1%),6(13.6%)and 5 ears(11.4%)in Group Ⅴ respectively for ineffective,effective,significantly effective and cured groups.There was no statistical difference in the prognosis of non-elderly adult patients with SSNHL and different blood glucose levels by Kruskal-Wallis test(H=4.577,P=0.334).4.Comparison of the results of laboratory related indicators in non-elderly adult patients with SSNHL and different blood glucose levels.Through the Kruskal-Wallis test of multiple independent samples for statistical analysis,the total cholesterol(P=0.025),triglyceride(P=0.000),white blood cell(P=0.000),neutrophil(P=0.001),lymphocyte(P=0.048),monocyte(P=0.022),and hemoglobin(P=0.017)were different in non-elderly adult patients with SSNHL and different blood glucose.Non-elderly adult patients with SSNHL and diabetes generally had higher blood lipid and inflammatory indicators.5.Analysis of related factors of clinical classification in non-elderly adult patients with SSNHL and different blood glucose levels.The clinical classification was positively correlated with neutrophil(r=0.280,P=0.046)in Group I,negatively correlated with blood platelet(r=-0.291,P=0.038)in Group III,and positively correlated with white blood cell(r=0.455,P=0.001),neutrophil(r=0.327,P=0.019),lymphocyte(r=0.460,P=0.001)and monocyte(r=0.422,P=0.002)in Group IV.6.Analysis of related factors for the degree of hearing loss in non-elderly adult patients with SSNHL and different blood glucose levels.The degree of hearing loss was positively correlated with lymphocyte(r=0.328,P=0.017)and monocyte(r=0.302,P=0.028)in Group II,negatively correlated with fibrinogen(r=-0.304,P=0.030)and positively correlated with white blood cell(r=0.408,P=0.003),neutrophil(r=0.320,P=0.022),lymphocyte(r=0.378,P=0.006),and monocyte(r=0.403,P=0.003)in Group IV,and negatively correlated with total cholesterol(r=-0.377,P=0.012)and prothrombin time(r=-0.345,P=0.022)in Group V.7.Analysis on the influencing factors of prognosis in non-elderly adult patients with SSNHL and different blood glucose levels.The prognosis was negatively correlated with activated partial thrombin time(r=-0.307,P=0.029)and hemoglobin(r=-0.286,P=0.042)in Group I.In other groups,there were no significant correlation between blood lipids,coagulation,inflammation,hemoglobin and the prognosis of non-elderly adult patients with SSNHL.8.Comparison of the concomitant symptoms or diseases in non-elderly adult patients with SSNHL and different blood glucose levels.There were 45(90.0%),10(20.0%),8(16.0%),9(18.0%)and 8 cases(16.0%)in Group I,45(93.7%),3(6.3%),11(22.9%),10(20.8%)and 5 cases(10.4%)in Group Ⅱ,47(97.9%),5(10.4%),10(20.8%),5(10.4%)and 3 cases(6.3%)in Group Ⅲ,43(84.3%),7(13.7%),6(11.8%),8(15.7%)and 9 cases(17.6%)in Group Ⅳ,and 35(81.4%),3(7.0%),6(14.0%),9(20.9%)and 14 cases(32.6%)in Group Ⅴ respectively with tinnitus,vertigo,cerebral infarction or ischemia,arterial plaque,and hypertension.There was a statistical difference in hypertension(?2=13.206,P=0.010),and no significant difference in tinnitus(?2=9.081,P=0.059),vertigo(?2=5.936,P=0.024),cerebral infarction or ischemia(?2=2.987,P=0.056),and arterial plaque(?2=2.532,P=0.639)by Chi-square test.9.The gender distribution of non-elderly adult SSNHL patients with different blood glucose levels.There were 22(44.0%)and 28 cases(56.0%)in Group I(n=50),17(35.4%)and 31 cases(64.6%)in Group Ⅱ(n=48),22(45.8%)and 26 cases(54.2%)in Group Ⅲ(n=48),24(47.1%)and 27 cases(52.9%)in Group Ⅳ(n=51),and 32(74.4%)and 11 cases(25.6%)in Group Ⅴ(n=43)respectively for male and female.There was a significant difference in the gender distribution(?2=15.429,P=0.004)of non-elderly adult patients with SSNHL and different blood glucose levels.Most patients were male in Group V,and female in Group I,II,III and IV.10.The age distribution of non-elderly adult patients with SSNHL and different blood glucose levels.There were 12(24.0%),8(16.0%),10(20.0%)and 20 cases(40.0%)in Group I(n=50),10(20.8%),4(8.4%),12(25.0%)and22 cases(45.8%)in Group Ⅱ(n=48),8(16.7%),14(29.2%),15(31.2%)and 11(22.9%)in Group Ⅲ(n=48),2(3.9%),10(19.6%),19(37.3%)and 20 cases(39.2%)in Group Ⅳ(n=51),and 1(2.3%),4(9.1%),9(20.9%)and 29 cases(67.4%)in Group Ⅴ(n=43)respectively in patients aged 18-30,31-40,41-50 and 51-60 years old groups.Moreover,there was a significant difference in the gender distribution(?2=36.525,P=0.000)of non-elderly adult patients with SSNHL and different blood glucose levels by Chi-square test.Compared with Group I,there was statistical difference in Group IV(?2=10.149,P=0.017)and V(?2=11.887,P=0.008).Meanwhile,in comparison with Group II,there was statistical differences in Group III(?2=9.778,P=0.021),IV(?2=9.498,P=0.023)and V(?2=8.504,P=0.037).Finally,there was a statistical difference between Group III and V(?2=20.387,P=0.000).The incidence rate increased with the increase of age in non-elderly adult patients with SSNHL and higher blood glucose levels.11.Clinical classification of non-elderly adult SSNHL patients with diabetes.There were 3(6.8%),18(40.9%),9(20.5%)and 14 ears(31.8%)in the SSNHL patients with diabetes,and 43(20.9%),41(19.9%),55(26.7%)and 67 ears(32.5%)in the SSNHL patients without diabetes respectively for lowfrequency descending,high-frequency descending,flat descending and total deafness types.There was a statistical difference in the clinical classifications(?2=11.230,P=0.011)between two groups.There main classification was highfrequency descending type,followed by total deafness,flat descending and lowfrequency descending types in SSNHL patients with diabetes.However,there main classification was total deafness type,followed by flat descending,lowfrequency descending,and high-frequency descending types in SSNHL patients without diabetes.12.Analysis of the degree of hearing loss in non-elderly adult patients with SSNHL and diabetes.There were 7(15.9%),11(25.0%),8(18.2%)and 18 ears(40.9%)in the SSNHL patients with diabetes,and 31(15.0%),58(28.2%),44(21.4%)and 73 ears(35.4%)in the SSNHL patients without diabetes respectively for mild hearing loss,moderate hearing loss,severe hearing loss and extremely severe hearing loss.There was no statistical difference in the degree of hearing loss(Z=-0.421,P=0.674)between two groups by Mann-Whitney U test.13.Analysis of prognosis in non-elderly adult patients with SSNHL and diabetes.There were 29(65.9%),4(9.1%),6(13.6%)and 5 ears(11.4%)in the SSNHL patients with diabetes,and 110(53.4%),39(18.9%),17(8.3%)and 40ears(19.4%)in the SSNHL patients without diabetes respectively for ineffective,effective,significantly effective and cured types.There was no statistical difference in the prognosis(Z=-1.383,P=0.167)between two groups by MannWhitney U test.Conclusions: 1.The main classifications were high-frequency descending and total deafness types at higher fasting blood glucose in non-elderly adult patients with SSNHL.2.There was no significant correlation between the degree of hearing loss and prognosis,and blood glucose level in non-elderly adult patients with SSNHL.3.There was dyslipidemia in non-elderly adult patients with SSNHL and diabetes.And there were no significant correlations between the degree of hearing loss and prognosis,and blood lipids respectively.4.There was a correlation between hearing loss and hypercoagulable in non-elderly adult patients with SSNHL and higher blood glucose levels.5.Inflammation may participate in the occurrence and development of SSNHL in non-elderly adult patients with different blood glucose levels.6.Tinnitus may be the best common concomitant symptoms in non-elderly adult patients with SSNHL and different blood glucose levels.Non-elderly adult patients with SSNHL and diabetes may be simultaneously accompanied with hypertension.7.The incidence rate increased with the increase of age and blood glucose levels in non-elderly adult patients with SSNHL and higher blood glucose levels. |
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