中性粒细胞与淋巴细胞比值可预测特发性突发性感音神经性听力损失的诊断和预后：一项系统评价和荟萃分析。
Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of idiopathic sudden sensorineural hearing loss: A systematic review and meta-analysis.
作者信息
Chen Liquan, Zhang Gaohua, Zhang Zhanhui, Wang Yufeng, Hu Liren, Wu Jiayuan
机构信息
Affiliated Hospital of Guangdong Medical University, Zhanjiang Department of Information, Hospital Office, People's Hospital of Gaozhou, Gaozhou School of Public Health Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University Department of Scientific Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province, PR China.
出版信息
Medicine (Baltimore). 2018 Sep;97(38):e12492. doi: 10.1097/MD.0000000000012492.
BACKGROUND
Chronic inflammation has been regarded as one of the causes of idiopathic sudden sensorineural hearing loss (ISSHL). Several individual studies have reported the association between neutrophil-to-lymphocyte ratio (NLR) and ISSHL. However, the findings have been inconsistent, and these data have not been systematically evaluated. Thus, we conducted this meta-analysis to further explore the predictive value of NLR on formation and prognosis of ISSHL.
METHODS
A comprehensive literature search was performed to identify eligible studies based on PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. The Standardized mean deviation (SMD) with its 95% confidence interval (CI) was applied to be the effect size estimate.
RESULTS
A total 10 papers with 15 retrospective case-control studies, which included 1029 ISSHL patients (the case group) and 1020 healthy people (the control group), were selected for the meta-analysis of the relationship between NLR and onset of ISSHL. The NLR levels in the case group were observed to be higher than the control group (SMD = 1.65, 95% CI = 1.20-2.09, P < .001). The pooled results did not significantly change by the subgroup analyses based on study region, baseline matching, and laterality. Moreover, 9 publications with 12 retrospective cohort studies, which included 590 recovered ISSHL patients and 438 unrecovered ISSHL patients, explored the association between NLR and ISSHL prognosis, and the combined data showed that the NLR value was much higher in unrecovered patients rather than recovered patients (SMD = 1.27, 95% CI: 0.62-1.92, P < .001). The subgroup analyses based on study region, laterality, type of steroid, medication administration, maintenance treatment, follow-up period, and definition of "recovered" further supported these results.
CONCLUSION
The results of this meta-analysis suggest that NLR might be a useful biomarker to determine the onset and prognosis of ISSHL.
背景
慢性炎症被认为是特发性突发性感音神经性听力损失（ISSHL）的病因之一。几项单独的研究报告了中性粒细胞与淋巴细胞比值（NLR）与ISSHL之间的关联。然而，研究结果并不一致，且这些数据尚未得到系统评估。因此，我们进行了这项荟萃分析，以进一步探讨NLR对ISSHL形成和预后的预测价值。
方法
基于PubMed、Embase、Web of Science和中国知网进行全面的文献检索，以确定符合条件的研究。采用标准化均数差（SMD）及其95%置信区间（CI）作为效应量估计值。
结果
共选择了10篇包含15项回顾性病例对照研究的论文，其中包括1029例ISSHL患者（病例组）和1020名健康人（对照组），用于对NLR与ISSHL发病之间的关系进行荟萃分析。观察到病例组的NLR水平高于对照组（SMD = 1.65，95% CI = 1.20 - 2.09，P <.001）。基于研究地区、基线匹配和患侧性的亚组分析，汇总结果没有显著变化。此外，9篇包含12项回顾性队列研究的论文，其中包括590例康复的ISSHL患者和438例未康复的ISSHL患者，探讨了NLR与ISSHL预后之间 的关联，合并数据显示未康复患者的NLR值远高于康复患者（SMD = 1.27，95% CI：0.62 - 1.92，P <.001）。基于研究地区、患侧性、类固醇类型、药物给药、维持治疗、随访期和“康复”定义的亚组分析进一步支持了这些结果。
结论
这项荟萃分析的结果表明，NLR可能是确定ISSHL发病的有用生物标志物。
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