突发性聋患者血清抗内皮细胞抗体与地塞米松治疗应答的相关性  

Association between anti-endothelial cell antibody and response to dexamethasone in sudden hearing loss

作　　者：于阅尽[1] 陆志成[2] 张红文[1] 曹云虹[1] 贾秀华[1] 黄卫[1] 郝亚楠[1] 

机构地区：[1]上海市第七人民医院耳鼻咽喉科,上海200137 [2]上海市第七人民医院检验科

出　　处：《临床耳鼻咽喉头颈外科杂志》2011年第4期145-148,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市浦东新区社发局青年基金(No:PW2008B-5)

摘　　要：目的:探讨血清抗内皮细胞抗体(AECA)对地塞米松治疗突发性聋(SHL)的疗效预测作用。方法:使用ELISA法检测48例SHL患者和30例正常对照者AECA,同时检测SHL患者治疗前后受损频率平均听阈,AECA阳性和阴性患者均给予10mg/d静脉地塞米松治疗5d,减量至5mg/d,5d后停药。比较AECA阳性和阴性突发性聋患者对地塞米松的治疗反应,对治疗前血清AECA水平与平均听阈改变进行相关性分析。结果:AECA阳性率在SHL组和正常对照组中分别为68.75%(33/48)和23.33%(7/30),差异有统计学意义(P<0.01)。AECA阳性及阴性SHL患者中分别有81.8%(27/33)和33.3%(5/15)对地塞米松治疗产生应答,差异有统计学意义(P<0.01)。治愈、显效、有效及无效在AECA阳性组分别为21.2%(7/33)、33.3%(11/33)、27.3%(9/33)和18.2%(6/33),而AECA阴性组则为0、13.3%(2/15)、20.0%(3/15)和66.7%(10/15),差异有统计学意义(P<0.01)。29例患者中除5例血清AECA浓度大于263μg/L外,其余听力恢复与血清AECA水平呈正相关(r=0.808 4,P<0.01)。结论:SHL患者血清AECA阳性率显著高于正常对照组,可以作为地塞米松治疗SHL的预后指标。Objective：To investigate relationship between anti-endothelial cell antibody（AECA） and response to dexamethasone in sudden hearing loss（SHL）.Method：Forty-eight SHL patients and thirtynormal controls with SHL were recruited in present study.AECA was detected by ELISA in serum of all normal controls and SHL patients as well as pure-tone average was examined by electronic audiometry during treatmentin SHL patients.Both AECA-positive and-negative subjects received 10 mg/d venous dexamethasone for 5 days followed by gradual tapering of dose of 5 mg/d for another 5-day.Then pure-tone average was reexamined.Differences in hearing recovery between AECA-positive and-negative subjects and relationship between AECA level and hearing recovery were analyzed.Result：The prevalence of AECA detection was 68.75%（33 of 48 patients） in SHL patients,with significant difference compared with control subjects with 23.33%（7 of 30 controls）（P0.01）.After treatment,rates of response to dexamethasone in AECA-positive and-negative SHL patients were 81.8%（27 of 33 patients） and 33.3%（5 of 15 patients）,respectively.Meanwhile,there was a significant difference in cure,excellent recovery,partly recovery and invalid between AECA-positive and-negative groups [（21.2%（7/33）,33.3%（11/33）,27.3%（9/33） and 18.2%（6/33） versus 0,13.3%（2/15）,20.0%（3/15） and 66.7%（10/15）,P0.01].Except 5 subjects with AECA level more than 263 μg/L,hearing recovery was correlated to pretreatment AECA level（r=0.808 4,P0.01）.Conclusion：In sudden HL patients treated with dexamethasone,AECA might represent a serological marker of prognosis.

关 键 词：听觉丧失 突发性 抗内皮细胞抗体 地塞米松 预后 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]