| Objective:To explore the correlation between the results and parameters of thromboelastography(TEG)and the clinical features and prognosis of sudden sensorineural hearing loss(SSNHL)in the elderly,and to explore the relevant factors affecting the efficacy of SSNHL in the elderly.Methods:The clinical data of 135 elderly patients(≥ 60 years old)with SSNHL diagnosed in XXXXXXXX hospital from January 2021 to June 2011 were retrospectively analyzed,including sex,age,side of disease,course,dizziness,underlying disease,degree of hearing loss,type of hearing curve,vestibular function,MRI results of inner ear,TEG results and fibrinogen level.Audiology,hematology,vestibular function and imaging were examined before treatment,and the curative effect was evaluated after classification.According to the TEG results at admission,the patients were divided into normal group and abnormal group.The relationship between TEG results and clinical characteristics of elderly patients with SSNHL was analyzed.The relationship between MA value,R value,K value,Angle value of TEG test results and the degree of hearing loss,the type of audiogram curve and prognosis was analyzed.Finally,the relationship between the efficacy and clinical characteristics of elderly patients with SSNHL was analyzed.The chi-square test,nonparametric test and logistic regression analysis were used to analyze the relationship between TEG results and clinical features and prognosis of elderly SSNHL.Results:1.The results of abnormal TEG were significantly correlated with the severity of severe hearing loss(P=0.003),type of curve of hearing loss(P=0.012),hypertension(P=0.028),diabetes(P=0.017)and high fibrinogen(P<0.001)in elderly patients with SSNHL,which was confirmed by Logistic regression analysis.There were no statistical differences between TEG results and sex(P=0.541),age(P=0.462),sideline(P=0.876),duration(P=0.966),vertigo(P=0.414),inner ear MRI(P=0.714)and vestibular dysfunction(P=0.483).2.Further analysis of MA,R,K and Angle values of TEG parameters and clinical features and prognosis of elderly SSNHL.Degree of hearing loss:MA value(P=0.013)and Angle value(P=0.014)are correlated with the degree of severe and extremely severe hearing loss,and the values increase with the degree of hearing loss;Type of hearing curve:MA value(P=0.026),R value(P=0.026)and Angle value(P=0.031)are statistically significant in the difference between the totally deaf and the low frequency descending types,and the difference between the MA value between the totally deaf and the high frequency descending types(P=0.032)and the flat type(P=0.047)is statistically significant;Prognosis:R value is closely correlated with the poor prognosis(P=0.01),and the worse the prognosis is,the smaller the value of R.3.The hearing efficacy of elderly patients with SSNHL was significantly correlated with abnormal TEG results,hearing loss,type of hearing curve,history of diabetes and hypertension.The total effective hearing rate of patients with normal TEG was significantly higher than that of patients with abnormal TEG(P=0.012);that of patients with mild to moderate hearing loss was significantly higher than that of patients with severe to very severe hearing loss(P=0.09);that of patients with low frequency descent was significantly higher than that of patients with high frequency descent(P=0.006),flat descent(P=0.029)and total deaf(P=0.042);[11]The total effective hearing rate of patients with diabetes history(P=0.012)and hypertension history(P=0.008)was significantly lower.There was no significant correlation between hearing efficacy and gender(P=0.691),age(P=0.282),sideline(P=0.306),duration(P=0.753),vertigo(P=0.767),vestibular dysfunction(P=0.315)and MRI findings of inner ear(P=0.224)Conclusion:1.The results of TEG are closely related to the degree of hearing loss,the type of audiogram curve,the level of fibrinogen and the history of diabetic hypertension in elderly SSNHL.2.The parameters of TEG,such as MA,R and angle,were positively correlated with the clinical features and prognosis of SSNHL in the elderly.3.The efficacy of SSNHL in the elderly is closely related to the outcome of TEG,the degree of hearing loss,the type of hearing curve,fibrinogen level,and the history of diabetes/hypertension. |
