目的:慢性中耳炎(COM)是一种炎症性疾病,通常表现为耳漏和听力损失。细菌引起的炎症会导致内耳损伤,导致感觉神经性听力损失(SNHL)。这项研究旨在比较革兰氏阴性和革兰氏阳性培养患者中SNHL的患病率和严重程度,并检查循环单核细胞和中性粒细胞的浓度与细菌种类和SNHL之间的关联。
方法:这是一项回顾性研究。纳入胆脂瘤或慢性化脓性中耳炎伴耳漏患者。在耳镜下使用无菌拭子收集中耳分泌物,30分钟内送细菌检测。记录并分析感染不同病原体的患者的纯音测听和循环白细胞计数。采用Logistic回归分析确定与SNHL相关的危险因素。
结果:共纳入137例患者,包括45例感染革兰氏阴性菌的病人,41个革兰氏阳性菌,20种微生物感染,和31没有细菌生长。Logistic回归分析显示,细菌培养阳性感染(OR=7.265,95%CI2.219~23.786,p=0.001)是SNHL的独立危险因素。与革兰氏阳性菌患者相比,革兰氏阴性菌患者发生SNHL的风险更高(p<0.0001),听力损失更严重(p=0.005)。感染革兰氏阴性菌的COM患者显示循环单核细胞增加,与SNHL的发生相关(p=0.0343)。
结论:革兰氏阴性菌与循环单核细胞计数升高相关,并且具有更高的严重SNHL风险。
方法:4喉镜,2024.
OBJECTIVE: Chronic otitis media (COM) is an inflammatory disease that commonly presents with otorrhea and hearing loss. Bacteria-induced inflammation can cause inner ear damage, leading to sensorineural hearing loss (
SNHL). This study aimed to compare the prevalence and severity of
SNHL in patients with gram-negative versus gram-positive cultures and examine associations between the concentrations of circulating monocytes and neutrophils with bacteria species and SNHL.
METHODS: This was a retrospective study. Cholesteatoma or chronic suppurative otitis media patients with otorrhea were enrolled. Middle ear secretions were collected using sterile swabs under an otoscope, and sent for bacterial detection within 30 min. Pure tone audiometry and circulating leukocyte counts were recorded and analyzed in patients infected with different pathogens. Logistic regression analysis was used to identify the risk factors associated with
SNHL.
RESULTS: A total of 137 patients were enrolled, including 45 patients infected with gram-negative bacteria, 41 with gram-positive bacteria, 20 with polymicrobial infection, and 31 with no bacterial growth. Logistic regression analysis showed that bacterial culture positive infections (OR = 7.265, 95% CI 2.219-23.786, p = 0.001) were an independent risk factor for
SNHL. Patients with gram-negative bacteria had higher risks of
SNHL (p < 0.0001) and more severe hearing loss (p = 0.005) than those with gram-positive bacteria. COM patients infected with gram-negative bacteria showed an increase in circulating monocytes, which correlated with the occurrence of SNHL (p = 0.0343).
CONCLUSIONS: Gram-negative bacteria are associated with elevated circulating monocyte counts and have a higher risk of severe SNHL.
METHODS: 4 Laryngoscope, 134:3335-3341, 2024.