突发性聋患者血清HIF-α、内脂素、Caspase-3与听力损伤程度的关系及预测听力预后的价值

Relationship between serum HIF-α,Visfatin,Caspase-3 and degree of hearing impairment in sudden deafness patients and its predictive value for hearing prognosis

目的:探讨突发性聋患者血清缺氧诱导因子-α(HIF-α)、内脂素(Visfatin)、Caspase-3与听力损伤程度的关系及预测听力预后的价值。方法:收集113例突发性聋患者,其中轻度听力损伤32例,中度57例,重度24例。给以激素、改善循环、营养神经等药物治疗,10~15 d后评估听力预后,评价血清HIF-α、Visfatin、Caspase-3水平对听力预后的预测价值。结果:重度听力损伤患者血清HIF-α、Visfatin、Caspase-3水平高于轻、中度患者,中度听力损伤患者高于轻度患者(P<0.05)。预后不良患者血清HIF-α、Visfatin、Caspase-3水平高于预后良好患者(P<0.05)。血清HIF-α、Visfatin、Caspase-3水平与听力预后有关,OR(95%CI)分别为4.546(1.572~13.149)、3.782(1.306~10.952)、5.917(2.441~14.345)(P<0.05)。三者联合预测听力预后的敏感度为88.46%,特异度为90.80%,AUC为0.934(95%CI 0.871~0.972),高于单独预测[HIF-α、Visfatin、Caspase-3单独预测的AUC(95%CI)分别为0.717(0.625~0.798)、0.719(0.626~0.799)、0.747(0.656~0.824)]。结论:突发性聋患者血清HIF-α、Visfatin、Caspase-3水平与听力损伤程度有关,联合检测可用于预测听力预后。

Aim:To investigate the relationship between serum hypoxia-inducible factor-α(HIF-α),Visfatin,Caspase-3 and the degree of hearing impairment in sudden deafness patients and its predictive value for hearing prognosis.Methods:A total of 113 patients with sudden deafness were selected,including 32 cases of mild hearing loss,57 cases of moderate hearing loss,and 24 cases of severe hearing loss.Medications such as hormone therapy,improving circulation,and nourishing nerves were administered.After 10 to 15 days of treatment,the prognosis of hearing,and the predictive value of serum HIF-α,Visfatin and Caspase-3 for hearing prognosis was evaluated.Results:Serum HIF-α,Visfatin,Caspase-3 levels in patients with severe hearing impairment were higher that those with mild,moderate hearing impairment,and those with moderate hearing impairment were higher than those with mild hearing impairment(P<0.05).Serum HIF-α,Visfatin,Caspase-3 levels were higher in patients with poor prognosis than those with good prognosis(P<0.05).Serum HIF-α,Visfatin,Caspase-3 were associated with hearing prognosis,OR(95%CI)were 4.546(1.572-13.149),3.782(1.306-10.952),5.917(2.441-14.345)(P<0.05).AUC of the combination of the 3 factors was 0.934(95%CI 0.871-0.972),with a sensitivity of 88.46%and specificity of 90.80%,which was greater than that of the prediction alone,and AUC(95%CI)of serum HIF-α,Visfatin,Caspase-3 alone were 0.717(0.625-0.798),0.719(0.626-0.799),0.747(0.656-0.824).Conclusion:The serum levels of HIF-α,Visfatin and Caspase-3 in patients with sudden deafness are correlated with the degree of hearing impairment,and the combined detection could be used to predict hearing prognosis.