Göde Sercan, Turhal Göksel, Kaya İsa, Mavili Halil İbrahim, Kirazlı Tayfun
Department of Otolaryngology, Ege University School of Medicine, İzmir, Turkey.
J Int Adv Otol. 2018 Apr;14(1):44-47. doi: 10.5152/iao.2017.2780. Epub 2017 Jun 21.
The aim of this study was to evaluate procalcitonin and high sensitive c-reactive protein (hs-CRP) levels in idiopathic sudden sensorineural hearing loss (ISSNHL) patients and assess their correlations with the clinical prognosis.
Twenty-three ISSNHL patients were included in the study (group A). The control group was consisted of 19 patients (group B). Procalcitonin and hs-CRP levels were compared between the groups. The relationship between procalcitonin and hs-CRP levels and the configuration of the audiogram, degree of hearing loss [partial or total ( > 90 dB)], and status of improvement (improvement of > 15 dB in the first month PTA) were evaluated.
The mean age was 47.91±15.73 years (range 21-73 years) and 35.16±15.67 years (range 19-79 years) in groups A and B, respectively. Seven patients (30.4%) had underlying cardiovascular risk factors. Mean procalcitonin levels were 0.057±0.025 µg/L and 0.041±0.016 µg/L in groups A and B, respectively. Mean hs-CRP levels were 0.461±1.335 mg/dL and 0.129±0.125 mg/dL in groups A and B, respectively. Procalcitonin levels were significantly higher in group A than in group B (p=0.018). Procalcitonin levels were significantly lower (0.035±0.013 µg/L vs. 0.061±0.025 µg/L) in patients with low-frequency hearing loss (p=0.04). ROC analysis of procalcitonin values revealed that area under the curve was 0.80 (p=0.005). A cut-off procalcitonin level of 0.45 µg/L yielded a sensitivity of 90% and specificity of 56.2%.
In conclusion, as a proinflammatory marker, procalcitonin levels were higher in ISSNHL patients than in healthy controls. The procalcitonin level was significantly lower in upsloping-type hearing loss patients. This finding could be regarded as an indirect indicator of pathogenesis.
本研究旨在评估特发性突发性感音神经性听力损失（ISSNHL）患者的降钙素原和高敏C反应蛋白（hs-CRP）水平，并评估它们与临床预后的相关性。
本研究纳入了23例ISSNHL患者（A组）。对照组由19例患者组成（B组）。比较两组之间的降钙素原和hs-CRP水平。评估降钙素原和hs-CRP水平与听力图形态、听力损失程度[部分或全部（>90dB）]以及改善情况（第一个月纯音平均听阈改善>15dB）之间的关系。
A组和B组的平均年龄分别为47.91±15.73岁（范围21 - 73岁）和35.16±15.67岁（范围19 - 79岁）。7例患者（30.4%）有潜在心血管危险因素。A组和B组的平均降钙素原水平分别为0.057±0.025μg/L和0.041±0.016μg/L。A组和B组的平均hs-CRP水平分别为0.461±1.335mg/dL和0.129±0.125mg/dL。A组的降钙素原水平显著高于B组（p = 0.018）。低频听力损失患者的降钙素原水平显著更低（0.035±0.013μg/L对0.061±0.025μg/L）（p = 0.04）。降钙素原值的ROC分析显示曲线下面积为0.80（p = 0.005）。降钙素原水平截断值为0.45μg/L时，敏感性为90%，特异性为56.2%。
总之，作为一种促炎标志物，ISSNHL患者的降钙素原水平高于健康对照组。上斜坡型听力损失患者的降钙素原水平显著更低。这一发现可被视为发病机制的间接指标。
