血常规相关指标对突聋患者预后的预测作用

Correlation between Change of Routine Blood Parameters and Prognosis of SSHL Patients

目的探讨突发性聋(sudden sensorineural hearing loss,SSHL)患者平均血小板体积(mean platelet volume,MPV)、中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte,NLR)变化与听力下降程度及预后的关系。方法回顾性分析2012年1月至2015年5月172例突发性聋患者的临床资料,分析比较不同听阈曲线类型(低频下降型、平坦下降型、高频下降型及全聋型)及疗效(痊愈、显效、有效和无效)的突聋患者间血常规相关指标(白细胞、中性粒细胞、淋巴细胞、平均血小板体积及中性粒细胞/淋巴细胞比值)的分布特征。结果低频型、平坦型、高频型及全聋型突聋患者血浆MPV、NLR值依次升高,差异有统计学意义(P值分别为0.003和0.01);治疗有效组MPV、NLR明显低于无效组(P<0.01);突聋患者的预后与入院24小时内MPV、NLR负相关,与淋巴细胞计数正相关;NLR和MPV判断预后的敏感度和特异度分别为66.2%和85.5%、58.4%和86.7%。结论突聋患者MPV、NLR与听阈曲线类型和预后有关,入院24时内中NLR可能对预后有较好的预测价值。

Objective To investigate the correlation between the mean platelet volume(MPV),neutrophil-to-lymphocyte(NLR)and the severity as well as prognosis of sudden sensorineural hearing loss(SSHL)patients.Methods A retrospective cohort study involved172patients with SSHL from January2012to May2015.The distribution characteristics of routine blood(white blood cells,neutrophil,lymphocyte,MPV,NLR)in different audiometric curves(hearing loss at low frequencies,flat type,high frequencies,and total deafness)and prognosis of recovery(complete,partial,slight,and no recovery)were analyzed by SPSS19.0analysis chi square test,and the prognosis was estimated by using the receiver operating characteristic curve(ROC).Results MPV and NLR levels in the severe and profound hearing loss group were significantly higher than that in different audiometric curves(P<0.01and P<0.01).MPV and NLR level in the partial recovery group and the no recovery group were significantly higher than that in the complete recovery group(P<0.01and P<0.01).The value of the MPV and NLR showed negative correlation with the prognosis(hearing recovery),and the lymphocyte was positive with the prognosis.The sensitivity and specificity of MPV and NLR count24hours after admission predicting the prognosis of hearing recovery were66.2%and85.5%,58.4%and86.7%,respectively.Conclusion The changes of MPV and NLR in SSHL patients are related to the severity of hearing loss,and NLR count at24hours after admission may play an important role in prognosis of this disease.