【摘要】 目的 通过Valsalva动作辅助系统右心声学造影技术(ASCE)探索突发性耳聋(SD)与右向左分流(RLS)之间的潜在关联性。方法 对突聋组(突发性耳聋患者)和对照组(非脑卒中、偏头痛、减压病患者)进行Valsalva动作辅助系统右心声学造影和经食管超声心动图(TEE)检测，SPSS软件进行统计分析右向左分流发生率、卵圆孔未闭(PFO)阳性率以及肺动静脉瘘(PAVF)的阳性率；以TEE为诊断标准统计突聋组患者右心声学造影诊断性指标。结果 突聋组的RLS发生率及卵圆孔未闭(PFO)阳性率高于对照组，其差异有统计学意义(P<0.05);肺动静脉瘘(PAVF)阳性率两组间无统计学意义差异(P>0.05)。ASCE诊断PFO的受试者工作特征(ROC)曲线下面积(AUC)为0.951(95%CI:0.852～1.000),诊断性灵敏度为94.12%,特异度为100.00%,准确度为94.74%。结论 突发性耳聋患者的RLS发生率高于非突发性耳聋患者，突发性耳聋与PFO-RLS可能存在关联性。更多还原

【Abstract】 Objective To investigate the potential association between sudden deafness(SD) and right-to-left shunt(RLS) using Valsalva maneuver-augmented agitated saline contrast echocardiography(ASCE). Methods Patients with SD(SD group) and a control group(without stroke, migraine, or decompression sickness) underwent Valsalva maneuver-augmented agitated saline contrast echocardiography and transesophageal echocardiography(TEE). SPSS software was utilized to analyze the incidence of RLS, positive rates of patent foramen ovale(PFO), and pulmonary arteriovenous fistula(PAVF). The diagnostic performance of ASCE in detecting RLS in the SD group was evaluated against TEE as the gold standard. Results The SD group exhibited significantly higher incidence of RLS and positive PFO rates compared to the control group(P<0.05). However, no statistically significant difference was observed in PAVF positivity between the two groups(P>0.05). ASCE demonstrated high diagnostic accuracy for PFO with an area under the ROC curve(AUC) of 0.951(95%CI: 0.852～1.000), sensitivity of 94.12%, specificity of 100.00%, and overall accuracy of 94.74%. Conclusions The incidence of RLS in patients with sudden deafness is higher than that in non sudden deafness patients, and there may be a correlation between sudden deafness and PFO-RLS.更多还原