超敏C反应蛋白及颈动脉粥样硬化与突发性聋的相关性研究

张俊瑶　王敏　海占兵　徐志勇　郝建海

摘要 目的 探討超敏C反应蛋白（Hs-CRP）及颈动脉粥样硬化与突发性聋发病的相关性。方法 选择2017年7月—2018年7月在我院住院治疗的40例突发性聋患者为研究组，同时选择40例无听力问题的患者为对照组，收集两组临床因素及Hs-CRP、颈总动脉分叉处内膜中层厚度（IMT）资料。采用单因素及多因素Logistic回归方法，分析Hs-CRP、颈总动脉分叉处IMT与突发性聋的关系。结果 单因素分析发现，研究组Hs-CRP、颈总动脉分叉处IMT高于对照组，差异有统计学意义（P<0.05），说明Hs-CRP、颈总动脉分叉处IMT水平与突发性聋有关系。多因素Logistic回归分析结果显示，血清Hs-CRP水平与突发性聋的关系具有统计学意义（P<0.05），血清Hs-CRP水平升高，突发性聋的危险性增大。未发现空腹血糖（GLU）、右侧劲动脉内膜中层厚度（IMT-R）、左侧劲动脉内膜中层厚度（IMT-L）与突发性聋发病有关联（P>0.05）。结论 血清Hs-CRP水平与突发性聋的发病有关，是突发性聋发病的独立危险因素。

关键词 超敏C反应蛋白;颈动脉粥样硬化;突发性聋

中图分类号  R764.437    文献标识码  A    文章编号  1671-0223（2020）10-038-04

CORRELATION BETWEEN HIGH SENSITIVE C-REACTIVE PROTEIN， CAROTID ATHEROSCLEROSIS AND SUDDEN DEAFNESS Zhang Junyao， Wang Min， Hai Zhanbing，et al.Department of Otorhinolaryngology， PLA 81st Group Army Hospital， Zhangjiakou 075000， China

Abstract  Objective To study the correlation between high-sensitivity C-reactive protein， carotid atherosclerosis and sudden deafness. Methods A total of 40 patients with sudden deafness who were hospitalized in our hospital from July 2017 to July 2018 were selected as the research group， and 40 patients without hearing problems were selected as the control group. We collected the clinical factors of two groups and the data of high-sensitivity C-reactive protein and intima-media thickness （IMT） of bifurcation of common carotid artery. Univariate and multivariate logistic regression methods were used to analyze the relationship between Hs-CRP， IMT at the bifurcation of the common carotid artery and sudden deafness. Results Univariate analysis found that the Hs-CRP and IMT of the common carotid artery bifurcation were higher in the research group than in the control group， and the difference was statistically significant （P<0.05）， the level of Hs-CRP， IMT of common carotid artery bifurcation are related to sudden deafness. Multivariate logistic regression analysis showed that the relationship between serum Hs-CRP level and sudden deafness was statistically significant（P<0.05）， as serum Hs-CRP levels increase， the risk of sudden deafness increases. There was no correlation was found between GLU， IMT-R， IMT-L and the onset of sudden deafness（P>0.05）. Conclusion Serum high-sensitivity C-reactive protein level is positively correlated with the occurrence of sudden deafness and is an independent risk factor for the occurrence of sudden deafness.

Key words  High-sensitivity C-reactive protein;Carotid atherosclerosis;Sudden deafness

突发性聋是指在72小时内突然发生的、原因不明的感音神经性听力损失，至少在相邻的两个频率听力下降≥20dBHL。有报道[1]美国突发性聋的发病率在11/10万～77/10万，随着年龄增大，其发病率明显增加。突发性聋的病因及发病机制尚未完全阐明，局部及全身的因素均可导致突发性聋的发生，常见的病因包括血管性疾病、病毒感染、自身免疫性疾病及传染性疾病、肿瘤等。另有报道[2-3]动脉粥样硬化危险因素包括年龄、性别、肥胖、血压、血脂也是突发性聋的危险因素。超敏C反应蛋白（Hs-CRP）是在动脉粥样硬化中发生、发展重要的炎性因子，是血管病变的危险因子及监测标志物。颈动脉粥样硬化是监测脑卒中及心肌梗死风险的重要指标[4]，劲动脉内膜中层厚度（IMT）可反应全身血管动脉粥样硬化程度。……