炎性细胞因子及淋巴细胞对突发性耳聋的诊断价值研究

Diagnostic value of inflammatory cytokines and lymphocytes in patients with sudden deafness

目的分析炎性细胞因子及淋巴细胞对突发性耳聋的诊断价值。方法选择2021年10月至2022年1月来我院耳科就诊的突发性耳聋患者90例(突聋组),40例健康体检者作为对照(对照组)。比较两组炎性细胞因子如白细胞介素(IL)-4、IL-6、肿瘤坏死因子-α(TNF-α)、IL-2、IL-10、干扰素-γ(IFN-γ)、IL-17A以及CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、CD4/CD8比值、B淋巴细胞、NK淋巴细胞水平,分析炎性细胞因子和淋巴细胞对突聋的诊断价值。结果两组IL-2、IL-17A水平比较,差异无统计学意义(P<0.05);突聋组IL-4、IL-6、TNF-α、IL-10、IFN-γ水平高于对照组(P<0.05),其诊断突聋的曲线下面积分别为0.685、0.646、0.667、0.601、0.608,敏感度分别为45.56%、40.00%、36.67%、31.11%、44.44%,特异度分别为92.50%、97.50%、95.00%、90.00%、75.00%。两组CD3^(+)T淋巴细胞绝对计数及其所占百分比比较,差异无统计学意义(P>0.05)。与对照组比较,突聋组CD4^(+)T淋巴细胞绝对计数较高,CD8^(+)T淋巴细胞绝对计数较低,CD4/CD8比值及B淋巴细胞绝对计数较高(P<0.05),但其所占百分比与对照组比较,差异均无统计学意义(P>0.05),突聋组NK淋巴细胞绝对计数及其所占百分比、总淋巴细胞绝对计数低于对照组(P<0.05)。CD4^(+)T、CD8^(+)T、B、NK、总淋巴细胞绝对计数和CD4/CD8诊断突聋的曲线下面积分别为0.577、0.706、0.601、0.741、0.754、0.629,敏感度分别为28.89%、46.67%、22.22%、48.99%、50.00%、41.11%,特异度分别为100.00%、90.00%、97.50%、100.00%、100.00%、85.00%。结论突聋患者存在炎性细胞因子及淋巴细胞亚群异常,其检测有助于诊断突聋的发生。

Objective To analyze the diagnostic value of inflammatory cytokines and lymphocytes in patients with sudden deafness.Methods A total of 90 patients with sudden deafness(sudden deafness group)and 40 healthy subjects(control group)from October 2021 to January 2022 were selected.The levels of inflammatory cytokines such as interleukin 4(IL-4),IL-6,IL-2,IL-10,IL-17A,tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ)and lymphocytes such as CD3^(+)T lymphocytes,CD4^(+)T lym-phocytes,CD8^(+)T lymphocytes,CD4/CD8 ratio,B lymphocytes and NK lymphocytes were detected in all subjects.The diagnostic value of inflammatory cytokines and lymphocytes in patients with sudden deafness was analyzed.Results There was no significant difference in IL-2 and IL-17A levels between the two groups(P<0.05).The levels of IL-4,IL-6,TNF-α,IL-10 and IFN-γin the sudden deafness group were higher than those in the control group(P<0.05).The areas under the ROC curve of IL-4,IL-6,TNF-α,IL-10 and IFN-γin the diagnosis of sudden deafness were 0685,0646,0667,0601 and 0608,respectively.The corresponding sensitivity were 4556%,4000%,3667%,3111%and 4444%,and the specificity was 9250%,9750%,9500%,9000%and 7500%,respectively.There was no significant difference in the absolute count and percentage of CD3^(+)T lymphocytes between the two groups(P>005).The absolute count of CD4^(+)T lymphocytes was higher,the absolute count of CD8^(+)T lymphocytes was lower in the sudden deafness group than those in the control group(P<0.05).However,the difference of the percentage of both was not statistically significant between the two groups(P>005).Compared with the control group,the ratio of CD4/CD8 and the absolute count of B lymphocytes was higher in the sudden deafness group(P<0.05),but there was no significant difference in the percentage of B lymphocytes(P>005).The absolute NK lymphocyte count and its percentage and the absolute total lymphocytes count in the sudden deafness group was lower than those in control group(P<0.05).The areas under the ROC curve of 0741,0754 and 0629,respectively.The corresponding sensitivity was 2889%,4667%,2222%,4899%,5000%,4111%,and the specificity was 10000%,9000%,9750%,10000%,10000%,8500%,respectively.Conclusions Sudden deafness patients have abnormalities in inflammatory cytokines and lymphocyte subsets.The detection of them is helpful for the diagnosis of sudden deafness.