血清可溶性血管细胞黏附分子-1、同型半胱氨酸以及D-二聚体水平与突发性耳聋患者内耳微循环障碍的关系

Correlations of serum levels of soluble vascular cell adhesion molecule-1, homocysteine and D-dimer with inner ear microcirculation disorders in patients with sudden sensorineural hearing loss

  • 摘要:
    目的 探讨血清可溶性血管细胞黏附分子-1(sVCAM-1)、同型半胱氨酸(Hcy)以及D-二聚体(D-D)水平与突发性耳聋患者内耳微循环障碍的关系。
    方法 选取突发性耳聋患者84例为研究对象,根据听力损失程度将患者分为轻度组(17例)、中度组(31例)和重度组(36例),根据听力图类型分为低频型组22例、高频型组33例和全频型组29例。选取同期健康体检者42例为健康组。比较不同听力类型及不同程度听力损失患者血清sVCAM-1、Hcy、D-D水平及内耳微循环动脉管径。采用Pearson相关性分析及线性回归分析验证上述血清指标与突发性耳聋患者内耳微循环各动脉管径间的相关性。
    结果 与健康组比较,低频型组、高频型组和全频型组的内耳微循环内听动脉、基底动脉、小脑前下动脉管径减小,且高频型组和全频型组小于低频型组,全频型组小于高频型组,差异有统计学意义(P < 0.05)。与健康组比较,低频型组、高频型组和全频型组的血清sVCAM-1、Hcy及D-D水平增高,且全频型组高于低频型组和高频型组,差异有统计学意义(P < 0.05)。与健康组比较,轻度组、中度组、重度组的血清sVCAM-1、Hcy及D-D水平增高,且重度组高于轻度组和中度组,差异有统计学意义(P < 0.05)。轻度组、中度组、重度组患者的内耳微循环内听动脉、基底动脉、小脑前下动脉管径小于健康组,差异有统计学意义(P < 0.05)。与轻度组比较,中度组、重度组的内听动脉、基底动脉、小脑前下动脉管径减小,且重度组小于中度组,差异有统计学意义(P < 0.05)。血清sVCAM-1、Hcy以及D-D与内听动脉、基底动脉、小脑前下动脉管径均呈负相关(P < 0.05)。内听动脉、基底动脉、小脑前下动脉管径与血清sVCAM-1、Hcy、D-D水平独立相关(P < 0.05)。
    结论 血清sVCAM-1、Hcy、D-D水平与突发性耳聋患者内耳微循环障碍密切相关。随着血清sVCAM-1、Hcy、D-D水平升高,患者耳聋及内耳微循环障碍程度加重。

     

    Abstract:
    Objective To investigate the correlations of serum levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), homocysteine (Hcy) and D-dimer (D-D) with inner ear microcirculation disorders in patients with sudden sensorineural hearing loss.
    Methods Eighty-four patients with sudden deafness were selected as subjects. Patients were divided into mild (17 cases), moderate (31 cases) and severe (36 cases) groups based on the degree of hearing loss. According to the types of audiogram maps, they were divided into low-frequency group (22 cases), high-frequency group (33 cases) and full-frequency group (29 cases). Forty-two healthy individuals undergoing physical examination during the same period served as healthy group. The levels of sVCAM-1, Hcy as well as D-D and inner ear microcirculation arterial diameters were compared among different audiogram types and degrees of hearing loss. Pearson correlation analysis and linear regression analysis were employed to verify the correlations between the aforementioned serum indicators and arterial diameters in inner ear microcirculation of affected patients.
    Results Compared with the healthy group, the diameters of the internal auditory artery, basilar artery, and anterior inferior cerebellar artery in the inner ear microcirculation were significantly reduced in the low-frequency type, high-frequency type and full-frequency type groups, with the high-frequency and full-frequency types being significantly smaller than the low-frequency type, and the full-frequency type being significantly smaller than the high-frequency type (P < 0.05). Serum levels of sVCAM-1, Hcy and D-D were significantly higher in the low-frequency type, high-frequency type and full-frequency type groups compared with the healthy group, with the full-frequency type being significantly higher than the low-frequency and high-frequency types (P < 0.05). Serum levels of sVCAM-1, Hcy and D-D were significantly higher in the mild, moderate and severe groups compared with the healthy group, with the severe group being significantly higher than the mild and moderate groups (P < 0.05). The diameters of the internal auditory artery, basilar artery and anterior inferior cerebellar artery in the inner ear microcirculation were significantly smaller in the mild, moderate and severe groups compared with the healthy group (P < 0.05). Compared with the mild group, the diameters of the internal auditory artery, basilar artery and anterior inferior cerebellar artery were significantly reduced in the moderate and severe groups, with the severe group being significantly smaller than the moderate group (P < 0.05). Serum levels of sVCAM-1, Hcy and D-D showed negative correlation with the diameters of the internal auditory artery, basilar artery and anterior inferior cerebellar artery (P < 0.05). Arterial diameters of the internal auditory artery, basilar artery and anterior inferior cerebellar artery were independently correlated with serum levels of sVCAM-1, Hcy and D-D (P < 0.05).
    Conclusion Serum levels of sVCAM-1, Hcy and D-D are closely related to inner ear microcirculation disorders in patients with sudden deafness. As serum levels of sVCAM-1, Hcy and D-D increase, the severity of hearing loss and inner ear microcirculation disorder intensifies.

     

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