血清C反应蛋白联合面神经高频超声检查对贝尔面瘫后口眼联带运动手术疗效预测价值  

Predictive effect of serum C-reactive protein combined with high-frequency ultrasound of facial nerve on the oral-ocular synkinesis after Bell Palsy

作　　者：林艳 周萍[1] 李艳贞[1] 李世亭[1] LIN Yan;ZHOU Ping;LI Yan-zhen;LI Shi-ting(Department of Neurosurgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院神经外科,上海200092

出　　处：《临床军医杂志》2021年第3期267-269,272,共4页Clinical Journal of Medical Officers

基　　金：国家自然科学基金面上项目(81671205)。

摘　　要：目的探讨血清C反应蛋白(CRP)联合面神经高频超声检查对贝尔面瘫后口眼联带运动手术疗效的预测价值。方法选取2019年6—12月于上海交通大学医学院附属新华医院颅神经疾病诊治中心接受面神经茎乳孔区松解术治疗的72例贝尔面瘫后口眼联带运动患者为研究对象。根据Sunnbrook面神经评定系统评分,将术后6个月Sunnybrook评分<30分者纳入预后不良组(n=18),将Sunnybrook评分≥30分者纳入预后良好组(n=54)。比较两组患者术前血清CRP水平、面神经直径、高频超声检查结果。采用多因素Logistic回归分析探讨影响患者预后的影响因素。采用受试者工作特征(ROC)曲线分析血清CRP联合面神经超声诊断对预后的预测价值。Hosmer-Lemeshow拟合优度检测校准能力。结果预后不良组患者术前血清CRP明显高于预后良好组,面神经直径明显大于预后良好组,两组比较,差异均有统计学意义(P<0.05)。预后不良组患者面神经高回声反射比例及回声清晰度为清晰比例分别为16.7%(3/18)、33.3%(6/18),均明显低于预后良好组的88.9%(48/54)、92.6%(50/54),两组比较,差异均有统计学意义(P<0.05)。血清CRP、面神经直径、回声清晰度是影响贝尔面瘫后口眼联带运动患者预后的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清CRP联合面神经超声诊断曲线下面积为0.88,特异度为0.86、敏感度为0.91。Hosmer-Lemeshow拟合优度检测χ^(2)=1.86,P=0.58>0.05。结论术前CRP联合面神经高频超声检查可有效地预测贝尔面瘫后口眼联带运动患者的手术疗效。Objective To investigate the predictive effect of serum C-reactive protein(CRP)combined with high-frequency ultrasound of facial nerve on the oral-ocular synkinesis after Bell Palsy.Methods A retrospective study was performed on 72 cases of patients with oral-ocular synkinesis after Bell Palsy who were admitted and underwent facial nerve neurolysis in mastoid foramen region from June to December 2019.According to the Sunnbrook facial nerve assessment system score,patients with Sunnybrook score<30 were included in the poor prognosis group(n=18)and patients with Sunnybrook score≥30 were included in the good prognosis group(n=54)6 months after surgery.Preoperative serum CRP level,facial nerve diameter and high-frequency ultrasound were compared between the two groups.Multivariate Logistic regression analysis was used to investigate the influencing factors of patients′prognosis.Receiver operating characteristic curve(ROC)was used to analyze the prognostic value of serum CRP combined with facial nerve ultrasound diagnosis.Hosmer-Lemeshow goodness of fit was used to test calibration capabilities.Results Preoperative CRP combined with high-frequency ultrasound of facial nerve can effectively predict the surgical outcome of patients with oral-ocular synkinesis after Bell Palsy.Preoperative serum CRP in the poor prognosis group was significantly higher than that in the good prognosis group,and the diameter of facial nerve was significantly larger than that in the good prognosis group,with statistical significance(P<0.05).The proportion of facial nerve hyperechoic reflex and clear echo clarity in the poor prognosis group were 16.7%(3/18)and 33.3%(6/18),respectively,which were significantly lower than 88.9%(48/54)and 92.6%(50/54)of the good prognosis group(P<0.05).Serum CRP,facial nerve diameter and echo clarity were independent risk factors affecting the prognosis of patients with oral-ocular synkinesis after Bell Palsy(P<0.05).ROC curve analysis results showed that the area under the curve of serum CRP combined with f

关 键 词：贝尔面瘫 口眼联带运动 神经松解术 C反应蛋白 面神经高频超声检查 

分 类 号：R745.12[医药卫生—神经病学与精神病学]