急性低频感音神经性听力损失中 IgE 水平升高：复发和梅尼埃病转化的预测因子。
High level of IgE in acute low-tone sensorineural hearing loss: A predictor for recurrence and Meniere Disease transformation.
机构信息
Department of Otolaryngology, Fourth Affiliated Hospital of China Medical University.
Department of Otolaryngology, Fourth Affiliated Hospital of China Medical University.
出版信息
Am J Otolaryngol. 2021 Mar-Apr;42(2):102856. doi: 10.1016/j.amjoto.2020.102856. Epub 2021 Jan 4.
BACKGROUND
Autoimmunity may play an important role in sudden onset sensorineural hearing loss. However, little is known about the relationship between immunoglobulin E (IgE) and acute low-tone sensorinerual hearing loss (ALHL).
OBJECTIVES
To investigate the relationship between IgE level and endolymphatic hydrops and outcomes of ALHL.
METHODS
A total of 242 subjects with sudden onset hearing loss, including 115 with ALHL and 127 with idiopathic sudden sensorineural hearing loss (ISSHL), were included in this study. Peripheral venous blood samples of 242 subjects were collected for detection. Clinical data, IgE level, and distribution of allergens were compared between the ALHL and ISSHL groups. The ALHL group received an electrocochleogram (ECochG) test and a follow-up in the outpatient unit or by telephone to evaluate outcomes.
RESULTS
Compared to the values in the ISSHL group, a significantly younger onset age (42.30±14.33 years old), higher female onset proportion (72/115, 62.61%), increased total IgE level (median: 66.47, interquartile range: 24.56, 180.96, IU/mL) and specific IgE level (median: 9.42, interquartile range: 1.42, 22.23 IU/mL) were noted in the ALHL group. A clear difference in allergen distribution was noted between the ALHL and ISSHL groups (p=.001). Total IgE and specific IgE levels were factors that contributed to the SP/AP ratio in the electrocochleogram (ECochG) (R=0.413) in ALHL group. Finally, during the follow-up (17.61±3.46 months) for the ALHL group, 37 subjects recurred, and 17 subjects developed Meniere Disease. In the ROC curve for ALHL recurrence, the area under the curve (AUC) of total IgE was 0.709 and that of specific IgE was 0.679. For MD transformation, the AUC of total IgE was 0.736 and that of specific IgE was 0.716.
CONCLUSIONS
High IgE levels correlated with an enhanced SP/AP ratio in ALHL. High IgE levels could be used as a predictor of ALHL recurrence and MD transformation.
背景
自身免疫可能在突发性感音神经性听力损失中起重要作用。然而，关于免疫球蛋白 E（IgE）与急性低频感音神经性听力损失（ALHL）之间的关系知之甚少。
目的
探讨 IgE 水平与内淋巴积水及 ALHL 预后的关系。
方法
纳入 242 例突发性听力损失患者，其中 115 例为 ALHL，127 例为特发性突发性感音神经性听力损失（ISSHL）。采集 242 例患者外周静脉血样进行检测。比较 ALHL 组和 ISSHL 组的临床资料、IgE 水平和过敏原分布。对 ALHL 组进行电耳蜗图（ECochG）检查，并通过门诊或电话进行随访，以评估结局。
结果
与 ISSHL 组相比，ALHL 组患者发病年龄较轻（42.30±14.33 岁），女性发病比例较高（72/115，62.61%），总 IgE 水平（中位数：66.47，四分位距：24.56，180.96 IU/mL）和特异性 IgE 水平（中位数：9.42，四分位距：1.42，22.23 IU/mL）均升高。ALHL 组和 ISSHL 组之间过敏原分布存在明显差异（p=.001）。总 IgE 和特异性 IgE 水平是 ALHL 组电耳蜗图（ECochG）中 SP/AP 比值的影响因素（R=0.413）。最后，在 ALHL 组的随访（17.61±3.46 个月）期间，37 例患者复发，17 例患者发生梅尼埃病。在 ALHL 复发的 ROC 曲线中，总 IgE 的 AUC 为 0.709，特异性 IgE 的 AUC 为 0.679。对于 MD 转化，总 IgE 的 AUC 为 0.736，特异性 IgE 的 AUC 为 0.716。
结论
高 IgE 水平与 ALHL 中增强的 SP/AP 比值相关。高 IgE 水平可作为 ALHL 复发和 MD 转化的预测因子。
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