同型半胱氨酸、血脂联合检测在突发性耳聋诊断中的意义

doi:10.3969/j.issn.1673-8640.2015.09.010

摘要/Abstract

摘要： 目的

探讨同型半胱氨酸(Hcy)、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]联合检测在突发感音神经性耳聋(SSHL)诊断中的意义。

方法

收集SSHL患者80例,以78名性别、年龄、种族相匹配的正常听力的人群作为正常对照组,分别检测2组血清Hcy、TC、TG和LDL-C浓度,分析其与SSHL的关系。

结果

SSHL组血清Hcy、TC、TG、LDL-C浓度分别为(16.16±3.94)μmol/L、(5.38±0.99)mmol/L、1.66(1.23~5.70)mmol/L、(3.49±0.78)mmol/L,均明显高于正常对照组[(12.59±2.24)μmol/L、(4.51±0.91)mmol/L、1.48(0.69~3.01)mmol/L、(2.59±0.80)mmol/L](P均<0.01)。相关分析发现Hcy与TC、TG、LDL-C呈正相关(r值分别为0.669、0.514、0.704,P均<0.01)。Logistic回归分析显示Hcy及LDL-C是SSHL的重要风险因素[OR值(95%可信区间)分别为1.850(1.256~2.725)、4.412(1.134~17.170)]。SSHL组中Hcy、LDL-C的阳性检出率分别为47.5%和51.3%,明显高于正常对照组(9.0%、14.1%,P均<0.01)。联合检测Hcy及LDL-C的阳性率可达66.3%,高于单项检测的阳性率。

结论

联合检测血清Hcy和血脂在SSHL预防、临床筛检和风险评估中均具有一定的价值。

关键词: 同型半胱氨酸, 胆固醇, 低密度脂蛋白, 突发性耳聋

Abstract: Objective

To study the significance of homocysteine(Hcy) and blood lipid detection [total cholesterol(TC), triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C)] in the diagnosis of sudden sensorineural hearing loss(SSHL).

Methods

A total of 80 patients with SSHL were enrolled, and 78 subjects without SSHL matched with SSHL group for sex, age and race were enrolled as control group. The serum levels of Hcy, TC, TG and LDL-C were detected. The relationship with SSHL was analyzed.

Results

The serum Hcy, TC, TG and LDL-C levels in SSHL group [(16.16±3.94) μmol/L, (5.38±0.99)mmol/L, 1.66(1.23-5.70)mmol/L and (3.49±0.78)mmol/L] were significantly higher than those in control group [(12.59±2.24)μmol/L, (4.51±0.91)mmol/L, 1.48(0.69-3.01)mmol/L and (2.59±0.80)mmol/L] (P<0.01). The correlation analysis showed that serum Hcy was positively correlated with TC, TG and LDL-C(r=0.669, 0.514 and 0.704, P<0.01). Logistic regression analysis showed that Hcy and LDL-C were important risk factors for SSHL[OR(95% confidence interval) were 1.85(1.256-2.725) and 4.412(1.134-17.170)]. The positive rates of Hcy and LDL-C were 47.5% and 51.3% in SSHL group and 9.0% and 14.1% in control group (P<0.01).The positive rate of the combined detection of Hcy and LDL-C was 66.3%, which was higher than any single-positive rate.

Conclusions

The combined detection of Hcy and blood lipid for SSHL has significance in preventing,diagnosing and risking assessment .

Key words: Homocysteine, Cholesterol, Low-density lipoprotein cholesterol, Sudden sensorineural hearing loss

中图分类号:

R446.1

陈宏, 杨虹, 齐国荣. 同型半胱氨酸、血脂联合检测在突发性耳聋诊断中的意义[J]. 检验医学, 2015, 30(9): 906-910.

CHEN Hong, YANG Hong, QI Guorong. Significance of homocysteine and blood lipid detection in the diagnosis of sudden sensorineural hearing loss[J]. Laboratory Medicine, 2015, 30(9): 906-910.

图/表 2

参考文献 14

[1]	中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.突发性聋的诊断和治疗指南(2005年,济南)[J].中华耳鼻咽喉头颈外科杂志,2006,41(8):569.
[2]	CHEN YS,EMMERLING O,ILGNER J,et al.Idiopathic sudden sensorineural hearing loss in children[J]. Int J Pediatr Otorhinolaryngol,2005,69(6):817-821.
[3]	TERANISHI M,KATAYAMA N,UCHIDA Y,et al.Thirty-year trends in sudden deafness from four nationwide epidemiological surveys in Japan[J]. Acta Otolaryngol,2007,127(12):1259-1265.
[4]	KLEMM E,DEUTSCHER A, MÖSGES R. A present investigation of the epidemiology in idiopathic sudden sensorineural hearing loss[J]. Laryngorhinootologie,2009,88(8):524-527.
[5]	MARCUCCI R,ALESSANDRELLO LIOTTA A,CELLAI AP,et al.Cardiovascular and thrombophilic risk factors for idiopathic sudden sensorineural hearing loss[J].J Thromb Haemost,2005,3(5): 929-934.
[6]	刘晓军,蔡东联.高同型半胱氨酸血症致动脉粥样硬化机制研究进展[J].肠外与肠内营养,2007,14(2):120-125.
[7]	李燕,张春来,卢峰,等.高同型半胱氨酸血症对平滑肌细胞的氧化损伤[J].首都医科大学学报,2012,33(2):251-254.
[8]	OROSKOVIC Z,SHEJBAL D,BICANIC G,et al.Influence of lipoproteins and fibrinogen on pathogenesis of sudden sensorineural hearing loss[J].J Laryngol Otol,2011,125(3): 258-261.
[9]	ROSSENBACH J,MUELLER GA,LANGE K,et al.Lipid-apheresis improves microcirculation of the upper limbs[J] . J Clin Apher,2011,26(4):167-173.
[10]	ORITA S,FUKUSHIMA K,ORITA Y,et al.Sudden hearing impairment combined with diabetes mellitus or hyperlipidemia[J]. Eur Arch Otorhinolaryngol,2007,264(4): 359-362.
[11]	胡可胜,马艳华,刘连红,等. 血清ox-LDL与非酒精性脂肪肝超声检查关系的探讨[J].检验医学,2014,29(2):118-121.
[12]	李宗锋,李洪臣.中年男性高脂血症患者伴发高同型半胱氨酸和高铁蛋白及高尿酸血症情况调查及分析[J].医学临床研究,2014,31(3):420-422.
[13]	WYSOKIN' SKI A,KOWMAN M,KLOSZEWSKA I. The prevalence of metabolic syndrome and Framingham cardiovascular risk scores in adult inpatients taking antipsychotics-a retrospective medical records review[J]. Psychiatr Danub,2012,24(3): 314-322.
[14]	KELLER JJ,WU CS,KANG JH,et al.Association of acute myocardial infarction with sudden sensorineural hearing loss: a population-based case-control study[J]. Audiol Neurootol,2013,18(1):3-8.

组别	例数	Hcy(μmol/L)	TC(μmol/L)	TG(μmol/L)	LDL-C(μmol/L)
SSHL 组	80	16.16±3.94	5.38±0.99	1.66(1.23~5.70)	3.49±0.70
正常对照组	78	12.86±2.24	4.51±0.91	1.48(0.69~3.01)	2.59±0.80
P值		0.000	0.000	0.006	0.000

组别	例数	Hcy(μmol/L)	TC(μmol/L)	TG(μmol/L)	LDL-C(μmol/L)
SSHL 组	80	16.16±3.94	5.38±0.99	1.66(1.23~5.70)	3.49±0.70
正常对照组	78	12.86±2.24	4.51±0.91	1.48(0.69~3.01)	2.59±0.80
P值		0.000	0.000	0.006	0.000

组别	例数	Hcy	LDL-C	Hcy + LDL-C
SSHL组	80	38(47.5)	41(51.3)	53(66.3)
正常对照组	78	7(9.0)	11(14.1)	15(19.2)
χ²值		28.7	24.68	35.62
P值		0.000	0.000	0.000

组别	例数	Hcy	LDL-C	Hcy + LDL-C
SSHL组	80	38(47.5)	41(51.3)	53(66.3)
正常对照组	78	7(9.0)	11(14.1)	15(19.2)
χ²值		28.7	24.68	35.62
P值		0.000	0.000	0.000

[1]	伏艺, 杨雪松, 金立钢, 翟红礼, 金小玲. sd-LDL-C与ACS患者远期不良心血管事件发生的相关性[J]. 检验医学, 2023, 38(9): 878-883.
[2]	伍曼玉, 刘丹, 黄新颜, 陈敏枝, 金晶晶. 孕前保健女性红细胞体积分布宽度标准差与同型半胱氨酸相关性分析[J]. 检验医学, 2023, 38(8): 781-783.
[3]	马建国, 李洪春. 冠心病患者血脂水平与心功能指标的相关性[J]. 检验医学, 2023, 38(7): 659-664.
[4]	郑志友, 李兴照, 谢雅革. 糖尿病心肌病患者HbA_1c、NT-proBNP、Hcy、SOD和TC水平的变化及其临床意义[J]. 检验医学, 2023, 38(3): 282-286.
[5]	苏珍珍, 邹继华, 王惠民, 徐炜烽, 丁方, 张晶梅, 王占科. 血清LDL-P与LDL-C检测结果一致性分析[J]. 检验医学, 2023, 38(2): 148-152.
[6]	安映红, 姚克纯, 苏成铭, 唐锦华, 杨利鑫, 高洁, 徐艳婷, 严秋红, 战宏艳, 马越云. 北京地区表观健康人群同型半胱氨酸水平调查[J]. 检验医学, 2023, 38(11): 1036-1040.
[7]	吴颖, 张立红, 高吟. HDL-C对T2DM患者缺血性脑卒中发病风险的预测价值[J]. 检验医学, 2023, 38(11): 1052-1056.
[8]	畅慧君, 张敏, 张其相. 血清Hcy水平与接受静脉溶栓治疗急性脑梗死患者短期预后的相关性[J]. 检验医学, 2023, 38(11): 1057-1061.
[9]	邢宝宝, 曹银芳. sd-LDL-C/LDL-C比值对AMI患者介入治疗后支架内再狭窄的预测价值[J]. 检验医学, 2023, 38(10): 941-945.
[10]	金中淦, 居漪, 张素洁. 2021年上海市同型半胱氨酸项目正确度验证结果分析[J]. 检验医学, 2023, 38(10): 967-970.
[11]	张一帆, 李长平, 张莉莉, 陈忠. 不同年龄心血管疾病患者血浆半乳凝集素3与低密度脂蛋白胆固醇的相关性[J]. 检验医学, 2023, 38(1): 8-13.
[12]	石鹏辉, 范伟光, 张珍, 苏苗苗, 孟娟, 路新利. CXCR5、sPD-1、Hcy在AIDS患者治疗过程中的动态变化及临床意义[J]. 检验医学, 2022, 37(2): 103-107.
[13]	王珊, 徐旻一, 王微, 蒋明明, 卢培, 熊仲波, 王蕾. H型高血压患者MTHFR基因C677T位点多态性检测的临床价值[J]. 检验医学, 2022, 37(11): 1012-1016.
[14]	沈盈, 徐晓萍, 张乐乐, 杜勇平, 孟超. 非空腹血液样本LDL-C检测的临床应用价值[J]. 检验医学, 2022, 37(11): 1049-1056.
[15]	张晰, 段明玥, 于壮, 魏孟姣, 张艳敏. LDLR基因突变致纯合子家族性高胆固醇血症外周血单核细胞LDLR表达的研究[J]. 检验医学, 2022, 37(10): 998-1001.