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论著:血清抗内皮细胞抗体在突发性耳聋诊断和预后中的价值
Anti Endothelial Cell Antibody in Patients with Sudden Hearing Loss: a Serum Marker for Diagnosis and Prognosis
于阅尽 曹云虹 陆志成 张红文 贾秀华 周义德
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作者单位:上海市第七人民医院耳鼻咽喉科
中文关键字:突发性耳聋;抗内皮细胞抗体;预后
英文关键字:Sudden hearing loss; Anti endothelial cell antibody; Prognosis
中文摘要:目的:检测突发性耳聋(sudden hearing loss, SHL)患者血清抗内皮细胞抗体(anti endothelial cell antibody, AECA)的水平并探讨其临床价值。方法:采用酶联免疫吸附方法检测67例SHL患者(SHL组)及30例健康者(对照组)的血清AECA水平。分析血清AECA与SHL患者性别、年龄、听力损失程度、听力下降类型及预后之间的关系。结果:AECA阳性率在SHL组、对照组中分别为70.15%(47/67)、23.33%(7/30),差异有统计学意义( P=0.0000)。SHL组血清AECA浓度显著高于对照组(P=0.0001)。血清AECA阳性分布与患者性别、年龄、听力下降类型无显著相关,但与听力下降程度和预后呈显著相关(P=0.0366;P=0.0324);且在41.031 ng/mL~162.26 ng/mL范围内时,AECA水平与患者预后呈正相关(r=0.7346, P=0.0000)。对照组和SHL组ROC曲线下面积为0.7657[标准误为0.0479,95%可信区间为(0.66830~0.85594)]。结论:血清中的AECA可能在SHL的发病机制中发挥了重要作用,AECA还有望作为患者筛选及指导预后的血清学指标。
英文摘要:Objective: To detect the serum level of anti endothelial cell antibody(AECA) in patients with sudden hearing loss (SHL) and investigate its relationships with clinical characteristics. Methods:A total of 67 patients with SHL and 30 normal controls were enrolled in this study. AECA was detected by ELISA in serum samples all SHL patients as well as normal controls. Results: The positiverate of AECA was 70.15%(47 of 67patients)with a statistically significant difference from controls (23.33%(7 of 30 controls)(P=0.0000). The levels of AECA were also significantly different between patients and controls (P=0.0001). The levels of AECA were significantly associated with hearing loss degree (P=0.0366) and recovery (P=0.0324). Furthermore, in the range from 41.031ng/mL to 162.26ng/mL, AECA was positively associated with recovery of hearing loss (r=0.7346, P=0.0000). The AUC under the ROC curve was 0.7657 [Std. Err 0.0479, 95% confidence interval(0.66830~0.85594)] indicating that AECA may be a useful diagnose marker. Conclusions: Serum AECA may play an important role in SHL and it is a potential serological marker for diagnosis and prognosis of SHL. The appearance of AECA is related to the good outcomes of partial SHL patients.
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