摘要
目的探讨血清微小RNA-204-5p(miR-204-5p)在突发性耳聋(SD)患者中的表达,及其与耳蜗功能和听力预后的关系。方法选取2020年10月至2023年10月该院收治的SD患者113例为病例组,根据SD患者听力预后情况将其分为预后不良组(n=43)和预后良好组(n=70)。另选取95例该院的体检健康者为对照组。采用实时荧光定量PCR及酶联免疫吸附试验检测血清miR-204-5p、内皮素-1(ET-1)水平,并分析其与患者耳蜗功能的关系;应用全自动血液流变仪检测血流动力学指标;采用多因素Logistic回归分析SD患者听力预后的影响因素;采用受试者工作特征(ROC)曲线分析血清miR-204-5p在SD患者听力预后中的预测价值。结果病例组血清miR-204-5p、ET-1水平及血流动力学指标血浆黏度(PV)、低切黏度(LSV)、全血高切黏度(HSV)均高于对照组(P<0.05)。miR-204-5p高表达组耳蜗功能异常的发生率高于miR-204-5p低表达组(P<0.05)。预后不良组血清miR-204-5p、ET-1水平及纯音平均听阈(PTA)、HSV、LSV、PV均明显高于预后良好组(P<0.05)。HSV、LSV、PV、miR-204-5p、ET-1是影响SD患者听力预后的相关因素(P<0.05)。血清miR-204-5p、ET-1联合血流动力学指标预测SD患者听力预后的曲线下面积为0.976,优于各自单独诊断(Z五者联合-HSV=3.464、Z五者联合-LSV=3.014、Z五者联合-PV=3.741、Z五者联合-miR-204-5p=3.476、Z五者联合-ET-1=2.829,P=0.001、0.003、<0.001、0.001、0.005),联合预测的灵敏度、特异度分别为95.35%、88.57%。结论SD患者血清miR-204-5p水平明显升高,其与耳蜗功能及听力预后有着密切联系,血清miR-204-5p、ET-1水平联合血流动力学指标检测对SD患者听力预后有更高的预测效能。
Objective To investigate the expression of serum microRNA-204-5p(miR-204-5p)in patients with sudden deafness(SD)and its relationship with cochlear function and hearing prognosis.Methods A total of 113 SD patients admitted to this hospital from October 2020 to October 2023 were selected as the case group.According to the hearing prognosis of SD patients,they were divided into a poor prognosis group(n=43)and a good prognosis group(n=70).Another 95 healthy people who underwent the physical examination were selected as the control group.Real-time fluorescent quantitative PCR and enzyme-linked immunosorbent assay were used to detect serum levels of miR-204-5p and endothelin-1(ET-1),and the relationship between them and cochlear function was analyzed.Automatic hemorheology instrument was used to detect the hemodynamic parameters.Multivariate Logistic regression was used to analyze the influencing factors of hearing prognosis in SD patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum miR-204-5p in hearing prognosis of SD patients.Results The serum levels of miR-204-5p and ET-1 and hemodynamic parameters including plasma viscosity(PV),low-shear viscosity(LSV)and whole blood high-shear viscosity(HSV)in the case group were significantly higher than those in the control group(P<0.05).The incidence of cochlear dysfunction in the miR-204-5p high expression group was higher than that in the miR-204-5p low expression group(P<0.05).The levels of serum miR-204-5p,ET-1,PTA,HSV,LSV and PV in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).HSV,LSV,PV,miR-204-5p and ET-1 were related factors affecting the hearing prognosis of SD patients(P<0.05).The area under the curve of serum miR-204-5p,ET-1 combined with hemodynamic parameters to predict the hearing prognosis of SD patients was 0.976.It was better than that of each individual diagnosis(Z five combination-HSV=3.464,Z five combination-LSV=3.014,Z five combination-PV=3.741,Z five combination-miR-204-5p=3.476,Z five combination-ET-1=2.829,P=0.001,0.003,<0.001,0.001,0.005).The sensitivity and specificity of combined prediction were 95.35%and 88.57%,respectively.Conclusion Serum miR-204-5p level is significantly increased in SD patients,which is closely related to cochlear function and hearing prognosis.Serum miR-204-5p and ET-1 levels combined with hemodynamic indicators have higher predictive efficiency for hearing prognosis in SD patients.
作者
涂厚义
吴超
彭雪梅
马双
TU Houyi;WU Chao;PENG Xuemei;MA Shuang(Department of Otolaryngology-Head and Neck Surgery,Zigong FourthPeople′s Hospital,Zigong,Sichuan 643000,China)
出处
《国际检验医学杂志》
2025年第5期575-579,584,共6页
International Journal of Laboratory Medicine
基金
四川省科技计划项目(2021YJ0049)。
