突发性聋患者中性粒细胞与淋巴细胞比值的特点及临床意义  

Characteristics and clinical significance of neutrophil to lymphocyte ratio in patients with sudden sensorineural hearing loss

作　　者：陈一博 安云芳[1] 赵长青[1] 索利敏[1] CHEN Yibo;AN Yunfang;ZHAO Changqing;SUO Limin(Department of ENT,the Second Hospital of Shan Xi Medical University,Shanxi Airway Inflammatory Diseases Neuroimmunity Laboratory,Taiyuan,030001,China)

机构地区：[1]山西医科大学第二医院耳鼻咽喉头颈外科山西省气道炎性疾病神经免疫实验室,太原030001

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第1期34-41,共8页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金面上项目(No:82171120、No:82171119)。

摘　　要：目的:炎症已被证实在突发性聋的发生发展中起重要作用,中性粒细胞与淋巴细胞比值(NLR)是与炎症程度呈正相关的生物标志物,本研究旨在寻找突发性聋患者与正常人群之间血清NLR的差异性,检验NLR对突发性聋发生及预后的预测效能,以期对突发性聋的临床诊疗起到指导作用。方法:本研究收集2023年1月至2024年3月收治的96例诊断为突发性聋的患者为病例组,以及同期收治的96例诊断为声带息肉的患者作为对照组。所有数据均在入院后收集,采用多因素logistic回归评估独立相关因素,构建列线图预测突发性聋发生的概率,使用受试者工作特性(ROC)曲线、校准曲线评估预测的准确性。结果:多因素逻辑回归结果显示,高水平NLR(OR2.215;95%CI 1.597~3.073;P<0.001)与突发性聋的发生独立相关,高龄(OR 1.036;95%CI 1.009~1.067;P=0.012)、高水平FIB(OR 2.35;95%CI 1.176~4.96;P=0.019)是突发性聋发生的危险因素,结合这3个因素进行森林图及列线图的绘制,ROC曲线及校准曲线表明该模型具有良好的临床实用性;低水平NLR(OR 0.598;95%CI0.439~0.816;P<0.001)与突发性聋的良好预后显著相关。结论:升高的NLR可作为预测突发性聋发生的独立危险因素;基于多因素logistic回归结果制作的列线图模型具有良好的预测效力;降低的NLR与突发性聋预后良好显著相关。Objective:Inflammation has been confirmed to play an important role in the occurrence and development of sudden sensorineural hearing loss(SSNHL),and the neutrophil-to-lymphocyte ratio(NLR) is a biomarker positively correlated with the degree of inflammation.This study aims to identify the difference in serum NLR between patients with SSNHL and normal population,and to evaluate the predictive efficacy of NLR for the occurrence and prognosis of SSNHL,thereby guiding the clinical diagnosis and treatment of SSNHL.Methods:In this study,96 patients diagnosed with SSNHL admitted to our department from January 2023 to March 2024 and 96 patients diagnosed with vocal cord polyps admitted to our department during the same period were recruited as a control group.Multivariate Logistic regression was used to evaluate independent related factors,and a nomogram was constructed to predict the probability of SSNHL.The receiver operating characteristic(ROC) curve and calibration curve were used to evaluate the accuracy of prediction.Results:Multivariate logistic regression analysis showed that a high level NLR(OR2.215;95%CI1.597-3.073;P<0.001) were independently associated with the presence of SSNHL.High age(OR1.036;95%CI1.009-1.067;P=0.012),high FIB(OR2.35;95%CI1.176-4.960;P=0.019) were the risk factor for SSNHL.Incorporating these 3 factors,a forest plot and a nomogram were generated.The ROC curve,nomogram and calibration curve showed that the model had good clinical practicability.A low NLR(OR0.598;95%CI0.439-0.816;P<0.001) was significantly associated with a favorable prognosis of SSNHL.Conclusion:Elevated NLR can serve as an promising biomarker for assessing the risk of SSNHL.The nomogram's calculation model may be utilized as a tool to estimate the probability of SSNHL.Low level NLR is significantly associated with a good prognosis of SSNHL.

关 键 词：突发性聋 中性粒细胞/淋巴细胞比值 中性粒细胞/胆红素比值 系统免疫炎症指数 列线图 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]