细菌性脑膜炎听力障碍的发生率及相关因素分析

发布时间：2018-03-19 08:57

  本文选题：细菌性脑膜炎　切入点：听力障碍　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：探讨细菌性脑膜炎(Bacterial Meningitis, BM)患者听力障碍(又称耳聋)的发生率及可能的影响因素。 方法：收集2007年1月至2012年1月广西医科大学第一附属医院BM患者172例,其中78例进行了纯音测听(Pure tone audiometry, PTA)、听性脑干诱发电位(Auditory brainstem responses, ABR)、声导抗(鼓室图、声反射)检测,根据结果将BM分为BM听力障碍组、BM无听力障碍组。收集无BM对照组56例,进行PTA或ABR检测。用Logistic回归分析判断BM患者听力障碍的影响因素。 结果：1、BM患者听力障碍发生率39.7%(31/78)高于正常对照组听力障碍的发生率7.1%(4/56),P＜0.05。＜18岁BM患者听力障碍发生率24.4%(10/41),≥18岁听力障碍发生率56.8%(21/37)。≥18岁BM患者比＜18岁者有更高的听力障碍发生率(56.8%vs24.4%, P0.05)。2、 BM患者感音神经性耳聋(Sensorineural Hearing Loss,SNHL)发生率83.9%(26/31),双边耳聋发生率80.6%(25/31),双耳重度以上耳聋发生率41.9%(13/31),双耳极重度以上耳聋发生率19.4%(6/31),固定性耳聋发生率83.9%(26/31)。3、单因素分析示脑膜刺激征阳性(OR=3.938).CSF糖≤1.0mmol／L (OR=6.224).血CRP≥20mg/L (OR=4.667)、年龄≥18岁(OR=4.069)是BM听力障碍的危险因素,P＜0.05；使用激素(B=-1.342,OR=0.261)、使用甘露醇(B=-1.042,OR=0.353)是听力障碍的保护因素,P＜0.05。多因素Logistic回归分析示脑膜刺激征阳性(P=0.003,OR=12.454)、 CSF糖≤1.0mol/L (P=0.030,OR=8.322)是听力障碍的高危因素。 结论：1、BM伴听力障碍发生率较高(39.7%)。2、BM听力障碍多为SNHL.双边耳聋、双耳重度以上耳聋、固定性耳聋。3、脑膜刺激征阳性、CSF糖≤1.0mmol／L、血CRP≥20mg／L、年龄≥18岁是BM听力障碍的危险因素,使用激素、使用甘露醇是BM听力障碍的保护因素。多因素Logistic回归分析示CSF糖≤1.0mmol／L、脑膜刺激征阳性是听力障碍的高危因素。
[Abstract]:Objective: to investigate the incidence of hearing impairment (also called deafness) in patients with bacterial meningitis (BMM) and its possible influencing factors. Methods: from January 2007 to January 2012, 172 cases of BM patients in the first affiliated Hospital of Guangxi Medical University were collected. Among them, 78 cases were examined by pure tone audiometry, auditory brainstem evoked potential (BAEP), auditory brainstem evoked potential (ABR), acoustic conductance (tympanogram, acoustic reflex). According to the results, BM was divided into BM hearing impairment group and BM without hearing disorder group, 56 cases of non-BM control group were collected and detected by PTA or ABR. Logistic regression analysis was used to determine the influencing factors of hearing impairment in BM patients. Results the incidence of hearing impairment in the patients with 1: 1 / BM was 39.7 / 78), which was higher than that in the normal control group (7.1 / 56) (P < 0.05). The incidence of hearing impairment in patients with BM < 18 years old was 24.410 / 41%, and the incidence rate of hearing disorders 鈮，

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