基于倾向得分匹配研究乳突气化程度与内淋巴囊发育的关系

A study on the relationship between mastoid pneumatization degree and endolymphatic sac development based on a propensity score matching analysis

目的探讨乳突气化程度与内淋巴囊发育情况的关系。方法回溯收集2019年1月至2021年5月就诊于耳鼻喉科且行颞骨CT检查的患者共145例(290耳),经过筛选后,根据患者乳突气化程度分为气化良好及气化不良,对其采用1∶1最临近匹配,倾向得分(PS)设置为0.02,基于年龄、中耳炎对协变量进行倾向得分匹配(PSM),该分析共产生了58对配对数据,随即测量后半规管中段至颞骨岩部后缘最短距离(P-P值),以其间接反映内淋巴囊发育情况,对不同乳突气化程度的P-P值进行统计学分析。结果P-P值的中位数(四分位间距)为2.26(1.49,3.08)mm;乳突气化程度与P-P值之间的差异无统计学意义,即乳突气化程度与内淋巴囊发育情况无关;经PSM处理后的协变量与乳突气化之间的差异均无统计学意义,即倾向得分匹配在临床研究中可以有效地处理非随机实验数据中的选择性偏倚问题;乳突气化程度与中耳炎之间的差异有统计学意义,即乳突气化程度与中耳炎性疾病相关,且乳突气化程度良好组,中耳炎发生率较低。结论乳突气化程度与内淋巴囊发育情况无关。

Objective To explore the relationship between the degree of mastoid pneumatization and the development of the endolymphatic sac.Methods A retrospective study of 145 patients(290 ears)who underwent temporal bone CT examination from January 2019 to May 2021 in the Department of Otolaryngology.After screening,the patients were divided into the well-pneumatized and the poorly-pneumatized groups,according to the degree of mastoid pneumatization.The 1∶1 closest match was adopted.The propensity score(PS)was set at 0.02.The propensity score matching(PSM)analysis was performed on covariates based on age and otitis media.The analysis produced 58 sets of paired data.The shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was used to indirectly reflect the development of the endolymphatic sac.The shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)of different degrees of pneumatization was analyzed statistically.Results The median(interquartile range)of the shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was 2.26(1.49,3.08)mm.The difference between the degree of mastoid pneumatization and the shortest distance between the middle of the posterior semicircular canal and the posterior edge of the posterior petrous surface(P-P value)was not statistically significant.That is,the degree of mastoid pneumatization was not associated with the development of the endolymphatic sac.There were no statistically significant differences in the general data processed after PSM in the two mastoid pneumatization groups.That is,the propensity score matching was effective in managing the selection deviation of non-random experimental data in clinical research.There was a statistically significant difference in the degree of mastoid pneumatization and otitis media;in the group with good mastoid pneumatization,the incidence of otitis media is lower.Conclusion There is no correlation between the degree of mastoid pneumatization and the development of the endolymphatic sac.