血白细胞及C-反应蛋白对评价突发性聋发病及预后的作用

The Role of Leukocyte and CRP in the Pathogenesis and Prognosis of Sudden Deafness

目的探讨血白细胞(WBC)及C-反应蛋白(C-reaction protein,CRP)与突发性聋发病及预后的关系。方法选取突发性聋患者162例,按照入院血常规检查结果及是否应用抗生素治疗,分为WBC正常组78例(WBC≤10×109/L),给予常规治疗;高WBC常规治疗组42例(WBC>10×109/L),给予常规治疗;高WBC联合治疗组42例(WBC>10×109/L),给予常规治疗同时联合抗生素治疗。分别检测三组患者治疗前后纯音听阈,比较治疗前后WBC及CRP水平的变化。结果高WBC常规治疗组有效率85.7%,高WBC联合治疗组有效率83.3%,均高于白细胞正常组的64.1%,差异有统计学意义(P<0.05);高WBC常规治疗组与高WBC联合治疗组有效率差异无统计学意义(P>0.05)。高WBC常规治疗组和高WBC联合治疗组治疗后WBC和CRP含量较治疗前均显著降低,差异均有统计学意义(P<0.05);但两组间治疗前后WBC和CRP水平相比,差异均无统计学意义(P>0.05)。低频下降型突聋患者中WBC升高者比例较其他听阈曲线类型者高,且治疗总有效率高于高频下降型和全频下降型患者。结论突聋的发病可能与炎症相关,但不是细菌感染引起的炎症反应,可能是机体的应激系统或免疫系统发挥作用,白细胞升高患者的治疗效果好于白细胞正常者,对白细胞升高的突聋患者采用抗生素治疗无临床意义。

Objective To investigate the relationship between blood leukocyte(WBC)and c-reactive protein(CRP)in the incidence and prognosis of sudden deafness.Methods One hundred and sixty-two patients,according to the blood routine assay and whether to apply antibiotics,were randomly divided into three groups.The WBC normal group with 78 cases(the WBC level<10×109/L),was given routine therapy;the high WBC regular treatment group with 42 cases(the WBC level>10×109/L)was given regular treatment for sudden deafness;the high WBC combined treatment group with 42 cases(the WBC level>10×109/L)was given regular treatment and antibiotics treatment.The WBC and CRP levels were detected before and after treatment.Results The effective rate of high WBC regular treatment group was 85.7%,and the effective rate of high WBC combined treatment group was 83.3%,both of them were higher than the level of the normal group with 64.1%(P<0.05).There was no statistically significant difference between the high WBC regular treatment group and the high WBC combined treatment group(P>0.05).After treatment,the levels of the leukocyte and CRP were significantly reduced compared with those before treatment,in the high WBC regular treatment group and the high WBC combined treatment groap(P<0.05).However,there was no significant difference in WBC content and CRP content in the two groups(P>0.05).Subgroup analysis showed that the proportion of patients with increased WBC was higher than those of patients with other types of sudden hearing loss,and the total effective rate of patients with low frequency decline was higher than those of patients with high frequency decline and full frequency hearing loss.Conclusion The etiology of sudden deafness may be associated with non-bacterial inflammation,which may be associated with the activation of the immune system.The treatment effect of the patients with high WBC level is better than that of the patients with normal white blood cells,so it is no clinical significance in the use of antibiotics in patients with sudden deafness.