突发性聋伴眩晕患者的临床特征、预后影响因素及预测模型构建

王朝霞; 张艳红; 魏建芳; 马芳; 关桂豪; 陈曦; 李娟娟

doi:10.3969/j.issn.1672-4933.2026.03.007

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突发性聋伴眩晕患者的临床特征、预后影响因素及预测模型构建

临床研究 | 更新时间：2026-05-25

- 突发性聋伴眩晕患者的临床特征、预后影响因素及预测模型构建
- Clinical Features, Prognostic Factors and Prediction Model in Sudden Sensorineural Hearing Loss with Vertigo
- 中国听力语言康复科学杂志 2026年24卷第3期页码：249-253
- 作者机构：
  
  深圳市龙岗区耳鼻咽喉医院深圳 518000
- 作者简介：
  
  王朝霞硕士副主任医师；研究方向：耳聋、耳鸣、眩晕
  李娟娟，E-mail：ljjent@163.com
- 基金信息：
  
  深圳市龙岗区科技计划医疗卫生项目“嵴帽疾病眼震机制研究”(LGWJ2022-109)
- DOI：10.3969/j.issn.1672-4933.2026.03.007
  中图分类号： R764.43
- 收稿：2026-01-29，
  
  纸质出版：2026-05-15
- 稿件说明：
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王朝霞,张艳红,魏建芳等.突发性聋伴眩晕患者的临床特征、预后影响因素及预测模型构建[J].中国听力语言康复科学杂志,2026,24(03):249-253.

WANG Zhao-Xia,ZHANG Yan-hong,WEI Jian-fang,et al.Clinical Features, Prognostic Factors and Prediction Model in Sudden Sensorineural Hearing Loss with Vertigo[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(03):249-253.
王朝霞,张艳红,魏建芳等.突发性聋伴眩晕患者的临床特征、预后影响因素及预测模型构建[J].中国听力语言康复科学杂志,2026,24(03):249-253. DOI： 10.3969/j.issn.1672-4933.2026.03.007.

WANG Zhao-Xia,ZHANG Yan-hong,WEI Jian-fang,et al.Clinical Features, Prognostic Factors and Prediction Model in Sudden Sensorineural Hearing Loss with Vertigo[J].Chinese Scientific Journal of Hearing and Speech Rehabilitation,2026,24(03):249-253. DOI： 10.3969/j.issn.1672-4933.2026.03.007.

摘要

目的

探讨突发性耳聋（sudden sensorineural hearing loss，SSNHL）伴眩晕患者的临床特征，分析影响其疗效的关键因素，构建与验证预测预后的Logistic回归模型，为突聋的个性化治疗决策提供依据。

方法

采用回顾性队列研究设计，纳入156例突发性耳聋患者。通过

检验和卡方检验进行单因素分析，在纳入发病时间、年龄、听力损失程度及耳鸣等变量基础上，构建2个递进的Logistic回归模型（基础模型和调整模型）进行多因素分析。模型1采用backward： LR法筛选变量，模型2在模型1基础上增加前庭功能相关变量，采用enter法分析。

结果

156例患者中，40～59岁占比最高（43.6%），男性53.8%（84/156），左侧发病52.6%（82/156），发病时间≤7天者62.2%（97/156），入院时极重度听力损失占比最高（39.7%，62/156）。卡方分析显示，发病时间与出院疗效显著相关（

=0.038），≤7 d就诊者的有效率（46.4%）明显高于≥15 d就诊者（21.2%），耳鸣与疗效呈临界相关（

=0.053），无耳鸣者有效率更高。Logistic回归显示，发病时间≥15 d（OR=0.201，95%CI=0.073～0.552）和耳鸣（OR=0.193，95%CI=0.043～0.865）为主要不良预后因

素，总胆固醇（total cholesterol，CHOL，OR=0.353，95%CI=0.133～0.940）、低密度脂蛋白（low-density lipoprotein，LDL，OR=3.763，95%CI=1.281～11.048）、凝血酶原时间（prothrombin time，PT，OR=0.825，95%CI=0.685～0.993）、活化部分凝血活酶时间（activated partial thromboplastin time，APTT，OR=1.093，95% CI=1.000～1.195）亦为独立影响因素，模型敏感度50.8%，特异度82.8%。纳入前庭功能指标后，总胆固醇（OR=0.363）、LDL（OR=3.454）、发病时间≥15 d（OR=0.187）、耳鸣（OR=0.160）和侧别（OR=0.454）仍为独立影响因素，模型敏感度和特异度分别提升至58.7%、84.9%。

结论

发病时间、初诊听力损失程度及耳鸣是影响突发性耳聋伴眩晕患者出院疗效的主要因素，其中发病至治疗时间≥15 d提示明显较差的预后；在此基础上，总胆固醇和低密度脂蛋白等血脂代谢指标及凝血功能参数亦与疗效相关，提示内耳微循环及高凝状态在疾病发生发展中具有重要作用。纳入自发性眼震、视频头脉冲试验（video head impulse test，vHIT）等前庭功能指标可进一步提高预后评估模型的性能，有助于早期识别预后不良的高风险人群，指导个体化治疗方案的制订。

Abstract

Objective

To investigate the clinical characteristics of patients with sudden sensorineural hearing loss (SSNHL) accompanied by vertigo

to analyze key factors influencing therapeutic outcomes

and to construct and validate a logistic regression model for prognostic prediction

thereby providing a basis for individualized treatment decision-making.

Methods

A retrospective cohort study was conducted including 156 patients with SSNHL. Univariate analysis was performed using t-tests and chi-square tests. Based on clinical variables such as time from onset

age

degree of hearing loss and tinnitus

two stepwise logistic regression models (a basic model and an adjusted model) were constructed for multivariate analysis. Model 1 adopted the backward: LR method for variable selection. Model 2

on the basis of Model 1

additionally incorporated vestibular function-related variables and was analyzed using the enter method.

Results

Among the 156 patients

40-59 years old accounted for the highest proportion (43.6%)

53.8% (84/156) were male

52.6% (82/156) had left-sided onset

62.2% (97/156) had onset time ≤7 days

and profound hearing loss on admission accounted for the highest proportion (39.7%

62/156). C

hi-square analysis showed that onset time was significantly correlated with discharge efficacy (

=0.038)

and the effective rate of patients treated ≤7 d (46.4%) was significantly higher than that of patients treated ≥15 d (21.2%). Tinnitus was marginally correlated with efficacy (

=0.053)

and the effective rate was higher in patients without tinnitus. Logistic regression showed that onset time ≥15 d (OR=0.201

95%CI=0.073-0.552) and tinnitus (OR=0.193

95%CI=0.043-0.865) were the main adverse prognostic factors. Total cholesterol (CHOL

OR=0.353

95%CI=0.133-0.940)

low-density lipoprotein (LDL

OR=3.763

95%CI=1.281-11.048)

prothrombin time (PT

OR=0.825

95%CI=0.685-0.993) and activated partial thromboplastin time (APTT

OR=1.093

95%CI=1.000-1.195) were also independent influencing factors. The model sensitivity and specificity were 50.8% and 82.8%

respectively. After including vestibular function indicators

total cholesterol (OR=0.363)

LDL (OR=3.454)

onset time ≥15 d (OR=0.187)

tinnitus (OR=0.160) and side (OR=0.454) were still independent influencing factors

and the model sensitivity and specificity increased to 58.7% and 84.9%

respectively. Conclusion Onset time

initial hearing loss degree and tinnitus are the main factors affecting the discharge efficacy of SSNHL patients with vertigo. Time from onset to treatment ≥15 d indicates a significantly worse prognosis. Blood lipid metabolism indicators' such as total cholesterol and LDL

as well as coagulation function parameters

are also related to efficacy

suggesting that inner ear microcirculation disturbance and hypercoagulable state play an important role in the disease process. The inclusion of vestibular function indicators' such as spontaneous nystagmus and video head impulse test (vHIT) can further improve the efficacy of the prognostic evaluation model

help to identify high-risk people with poor prognosis early

and guide the formulation of individualized treatment plans.

关键词

Keywords

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