血清雌二醇、otolin-1表达与绝经后良性阵发性位置性眩晕复发的相关性

Correlation between the expression of serum estradiol and otolin-1 and the recurrence of postmeno-pausal benign paroxysmal positional vertigo

目的探讨血清雌二醇、耳石蛋白-1(otolin-1)表达水平与绝经后良性阵发性位置性眩晕(BPPV)复发的相关性。方法选取2018年1月至2019年12月于北京老年医院眩晕治疗中心就诊且确诊为原发性BPPV的绝经后女性患者116例为研究对象,根据随访过程中患者复发情况分为复发组(27例)和未复发组(89例)。比较两组患者基础资料、实验室指标、合并症等,采用电化学发光法检测血清雌二醇水平,采用酶联免疫吸附法检测血清otolin-1水平。采用受试者工作特征(ROC)曲线评价血清雌二醇、otolin-1对绝经后BPPV患者复发的预测价值;利用多因素logistic回归分析影响绝经后BPPV患者复发的危险因素。结果复发组患者剧烈咳嗽人数所占比例高于非复发组(P<0.05);复发组雌二醇水平明显低于非复发组(P<0.05),otolin-1水平明显高于非复发组(P<0.05);ROC结果显示,血清雌二醇、otolin-1预测绝经后BPPV患者复发的曲线下面积(AUC)分别为0.852(95%CI:0.774~0.911).0.722(95%CI:0.631~0.801),截断值分别为18.09 pg/ml;361.79 pg/ml;多因素logistic回归分析结果显示,剧烈咳嗽、雌二醇≤18.09 pg/ml、otolin-1 >361.79 pg/ml6是影响绝经后BPPV患者复发的独立危险因素(P<0.05)。结论绝经后BPPV复发患者血清雌二醇水平下降,otolin-1水平上升,其水平异常是影响绝经后BPPV患者复发的独立危险因素。

Objective To explore the correlation between the expression levels of serum estradiol and otolin-1 and the recurrence of postmenopausal benign paroxysmal positional vertigo(BPPV).Methods A total of 116 postmenopausal female patients who were diagnosed with primary BPPV in the Vertigo Treatment Center of Beijing Geriatric Hospital from January 2018 to December 2019 were selected as the re-search objects.They were divided into recurrence group(27 cases)and the non-recurrence group(89 ca-ses)according to the recurrence during follow-up.The basic data,laboratory indexes and complications of the two groups were compared.The serum estradiol level was detected by electrochemilurminescence and the serum otolin-1 level was detected by enzyme-linked immunosorbent assay.The receiver operating character-istic(ROC)curve was used to evaluate the predictive value of serum estradiol and otolin-1 in the recurrence of postmenopausal BPPV patents;Multivariate logistic regression was used to analyze the risk factors of recurrence in postmenopausal BPPV patients.Results The proportion of severe cough in the recurrence group was higher than that in the non-recrrence group(P<0.05);the level of estradiol in the recurrence group was significantly lower than that in the non-recurrence group(P<0.05),and the level of otolin-1 was significantly higher(P<0.05);ROC results showed that the areas under the curve(AUCs)of serum estradiol and otolin-1 for predicting the recurrence of postmenopausal BPPV patients were 0.852(95%CI:0.774-0.911)and 0.722(95%CI:0.631-0.801)respectively,and the cut-off values were 18.09 pg/ml and 361.79 pg/ml respectively;Multivariate logistic regression analysis showed that severe cough,estradiol≤18.09 pg/ml,and otolin-1 >361.79 pg/ml were independent risk factors for reeurrence in postmenopausal BPPV patients(P<0.05).Conclusions The serum estradiol level of patients with postmenopausal BPPV recurrence decreases,and the level of otolin-1 increases.The abnormal level is an.independent risk factor affecting the recurrence of patients with postmenopausal BPPV.