凝血状态与突发性耳聋预后的相关性。
Correlation of coagulation states with prognosis of sudden deafness.
机构信息
First Department of Otolaryngology, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Minimally Invasive External Biliary Tract, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
出版信息
J Neurophysiol. 2023 May 1;129(5):1212-1217. doi: 10.1152/jn.00058.2023. Epub 2023 Apr 19.
Prognosis of sudden deafness remains a challenge in clinics because of inhomogeneity of the disease. Here we report our retrospective study aimed to explore the value of coagulative markers including activated partial thromboplastin time (APTT), prothrombin time (PT), plasma fibrinogen (FIB), and plasma D-dimer in the prognosis of patients. The study included a total of 160 patients, of whom 92 had valid responses, 68 had invalid responses, and 68 had ineffective responses. APTT, PT, and the levels of FIB and D-dimer in serum were compared between the two groups, and their prognostic values were determined in terms of area under the curve (AUC) in receiver operating curve (ROC) analysis, sensitivity, and specificity. The correlations of APTT, PT, and FIB to degree of hearing loss were also assessed. Serum APTT and PT, FIB, and D-dimer levels were lower in patients with sudden deafness who responded poorly to treatments. ROC analysis showed that APTT, PT, FIB, and D-dimer had high AUC, sensitivity, and specificity for nonresponders, particularly when used in combination (AUC = 0.91, sensitivity = 86.76%, and specificity = 82.61%). Patients with a higher degree of hearing loss (>91 dB) also demonstrated significantly lower values of APTT and PT and higher levels of serum FIB and D-dimer than those with a lower degree of hearing loss. Our study demonstrated that APTT, PT, and serum levels of FIB and D-dimer could serve as strong predictors of sudden deafness, potentiating the use of these tests to identify patients who respond poorly to treatments. Our retrospective study indicated that lower serum APTT and PT levels and higher fibrinogen (FIB) and D-dimer levels are characteristics associated with poor treatment responses among patients with sudden deafness. A combination of these levels had a high accuracy in identifying the nonresponders. APTT, PT, and serum levels of FIB and D-dimer could serve as strong predictors of sudden deafness, potentiating the use of these tests to identify patients who respond poorly to treatments.
突发性聋的预后仍然是临床的一个挑战,因为疾病的异质性。在这里,我们报告了我们的回顾性研究,旨在探讨包括活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血浆纤维蛋白原(FIB)和血浆 D-二聚体在内的凝血标志物在患者预后中的价值。这项研究共纳入了 160 名患者,其中 92 名患者有有效反应,68 名患者无有效反应,68 名患者无效。比较了两组患者的 APTT、PT 及血清 FIB、D-二聚体水平,并通过 ROC 分析中的曲线下面积(AUC)、灵敏度和特异性来确定其预后价值。还评估了 APTT、PT 及 FIB 与听力损失程度的相关性。治疗反应不佳的突发性聋患者的血清 APTT 和 PT、FIB 和 D-二聚体水平较低。ROC 分析表明,APTT、PT、FIB 和 D-二聚体对无反应者具有较高的 AUC、灵敏度和特异性,尤其是联合使用时(AUC=0.91、灵敏度=86.76%、特异性=82.61%)。听力损失程度较高(>91dB)的患者的 APTT 和 PT 值也明显较低,血清 FIB 和 D-二聚体水平较高。我们的研究表明,APTT、PT 和血清 FIB 和 D-二聚体水平可作为突发性聋的有力预测因子,增强了这些检测在识别治疗反应不佳患者中的应用。我们的回顾性研究表明,突发性聋患者治疗反应不佳的特征是血清 APTT 和 PT 水平较低,纤维蛋白原(FIB)和 D-二聚体水平较高。这些水平的联合具有较高的识别无反应者的准确性。APTT、PT 和血清 FIB 和 D-二聚体水平可作为突发性聋的有力预测因子,增强了这些检测在识别治疗反应不佳患者中的应用。