视频头脉冲试验联合血清CGRP、Ficolin-3对前庭神经炎患者的诊断价值分析  

Diagnostic value of video head impulse test combined with serum CGRP and Ficolin-3 in patients with vestibular neuritis

作　　者：郭君君 李斌[1] 周桂娟[1] 郭佳 GUO Junjun;LI Bin;ZHOU Guijuan;GUO Jia(Department of Neurology,Tangshan People′s Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市人民医院神经内科,河北唐山063000

出　　处：《国际检验医学杂志》2024年第23期2889-2893,2898,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20221821)。

摘　　要：目的 探究视频头脉冲试验(vHIT)联合血清降钙素基因相关肽(CGRP)、纤维凝胶蛋白-3(Ficolin-3)对前庭神经炎(VN)患者的诊断价值。方法 选取2021年3月至2023年9月来该院治疗的92例VN患者为VN组,选取同期92例在该院治疗的前庭性偏头痛(VM)患者为VM组,另选取92例同期在该院体检的健康者为对照组。比较3组血清中CGRP、Ficolin-3的水平;采用多因素Logistic回归分析VN发生的影响因素;采用受试者工作特征曲线分析vHIT联合血清CGRP、Ficolin-3水平对VN的诊断价值。结果 与对照组比较,VN组和VM组血清CGRP水平明显升高(P<0.05),Ficolin-3水平明显降低(P<0.05);与VM组比较,VN组血清CGRP水平及3个前庭眼动反射(VOR)增益不对称值明显升高(P<0.05),Ficolin-3水平明显降低(P<0.05);水平半规管(HC)不对称值、上半规管(AC)不对称值、后半规管(PC)不对称值、CGRP为VN发生的独立危险因素(P<0.05),Ficolin-3为VN发生的独立保护因素(P<0.05);AC不对称值、HC不对称值、PC不对称值联合诊断的曲线下面积(AUC)为0.872,三者联合诊断优于AC不对称值、HC不对称值单独诊断(Z_(三者联合-AC不对称值)=2.506、Z_(三者联合-HC不对称值)=2.329,P=0.012、0.020);HC不对称值、AC不对称值、PC不对称值、血清CGRP、Ficolin-3水平单独诊断VN的AUC分别为0.782、0.787、0.856、0.857、0.881,而五者联合诊断的AUC为0.948,显著优于各指标单独诊断(Z_(五者联合-HC不对称值)=4.578、Z_(五者联合-AC不对称值)=4.908、Z_(五者联合-PC不对称值)=3.085、Z_(五者联合-CGRP)=3.559、Z_(五者联合-Ficolin-3)=2.867,P<0.05)。结论 VN患者血清CGRP水平升高,Ficolin-3水平降低,且CGRP水平是VN发生的独立危险因素,Ficolin-3水平为VN发生的独立保护因素,vHIT联合CGRP、Ficolin-3诊断VN具有较高的价值。Objective To explore the diagnostic value of video head impulse test(vHIT) combined with serum calcitonin gene related peptide(CGRP) and Ficolin-3 in patients with vestibular neuritis(VN).Methods A total of 92 VN patients treated in the hospital from March 2021 to September 2023 were assigned as the VN group,92 vestibular migraines(VM) patients treated in the hospital during the same period were assigned as the VM group,and another 92 healthy individuals who underwent physical examination in the hospital were assigned as the control group.The levels of CGRP and Ficolin-3 in serum were compared in three groups.Multivariate Logistic regression was applied to analyze the influencing factors of VN occurrence.Receiver operating characteristic curve was applied to analyze the diagnostic value of vHIT combined with serum CGRP and Ficolin-3 levels for VN.Results Compared with the control group,the serum CGRP levels in the VN group and the VM group were obviously increased(P<0.05),while the Ficolin-3 levels were obviously reduced(P<0.05).Compared with the VM group,the serum CGRP level and 3 pairs of vestibular ocular reflex(VOR) gain asymmetry values in the VN group were obviously increased(P<0.05),while the Ficolin-3 level was obviously reduced(P<0.05).Horizontal semicircular canal(HC) asymmetry value,superior semicircular canal(AC) asymmetry value,posterior semicircular canal(PC) asymmetry value,and CGRP were independent risk factors for VN occurrence(P<0.05),while Ficolin-3 was an independent protective factor for VN occurrence(P<0.05).The area under the curve(AUC) of combined detection of AC asymmetry value,HC asymmetry value and PC asymmetry was 0.872,which was better than that of AC asymmetry value and HC asymmetry value alone(Z_(three combination-AC asymmetry value)=2.506,Z_(three combination-HC asymmetry value)=2.329,P=0.012,0.020).The AUC of HC asymmetry value,AC asymmetry value,PC asymmetry value,serum CGRP and Ficolin-3 for diagnosing VN was 0.782,0.787,0.856,0.857,and 0.881,respectively.The AUC of the combined

关 键 词：前庭神经炎 视频头脉冲试验 降钙素基因相关肽 纤维凝胶蛋白-3 

分 类 号：R446.1[医药卫生—诊断学]