关键词:

突发性耳聋, 半胱氨酸天冬氨酸蛋白酶3, 可溶性血管内皮生长因子受体-1, 预后, 关系

Abstract:

Objective　To explore the correlations between serum cysteine-aspartic protease-3 (Caspase-3) and soluble vascular endothelial growth factor receptor 1 (sFIt-1) levels and condition and prognosis in patients with sudden hearing loss. Methods　This study retrospectively analyzed 78 patients with sudden hearing loss treated at Shaanxi Provincial People's Hospital from January 2022 to January 2024 as a research group, including 46 males and 32 females, aged 32-76 (47.92±4.65) years, with a body mass index of 20.37-27.94 (24.57±3.24) kg/m². Additionally, 38 healthy individuals undergoing physical examinations were selected as a reference group, including 21 males and 17 females, aged 34-63 (48.23±4.81) years, with a body mass index of 19.86-22.51 (20.87±2.39) kg/m². Pure tone audiometry (PTA) was used to evaluate the patients with sudden hearing loss, and the patients were divided into 16 cases in the severe group (PTA >60 dBHL), 39 cases in the moderate group (PTA >40-60 dBHL), and 23 cases in the mild group (PTA 20-40 dBHL). All patients received treatments such as steroids and neurotrophic drugs for 10 days as a course of treatment, and the prognosis was evaluated after 10 days. According to the prognosis, the patients with sudden hearing loss after treatment were divided into a good prognosis group (57 cases) and a poor prognosis group (21 cases). Serum Caspase-3 and sFIT-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). General data of the subjects were collected, including gender, age, body mass index, course of disease, clinical symptoms, site of hearing loss, degree of hearing loss, and underlying diseases. Independent sample t test, repeated measure ANOVA, and χ² test were used for statistical analysis. Spearman rank correlation coefficient was used for correlation analysis. Multivariate logistic regression analysis was used to identify factors influencing poor prognosis in patients with sudden hearing loss. The receiver operating characteristic curve (ROC) was plotted to analyze the diagnostic value of serum Caspase-3 and sFIt-1 in predicting the prognosis of sudden hearing loss patients. Results　Serum Caspase-3 and sFIT-1 levels in the study group were higher than those in the reference group [(17.27±3.14) ng/L vs. (6.63±1.67) ng/L, (157.82±13.47) ng/L vs. (81.67±10.63) ng/L] (both P<0.05). Serum Caspase-3 and sFIT-1 levels in the severe and moderate groups were higher than those in the mild group, and the above indexes in the severe group were higher than those in the moderate group (all P<0.05). Spearman correlation analysis showed that serum Caspase-3 and sFIT-1 levels in patients with sudden hearing loss were positively correlated with the severity of the disease (r=0.881 and 0.841, both P<0.05). There were statistically significant differences in the age, severity of hearing loss, and serum Caspase-3 and sFIT-1 levels between the poor prognosis group and the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that the severity of hearing loss (OR: 0.009, 95%CI: 0.000-0.209), age (OR: 1.165, 95%CI: 1.049-1.293), and serum Caspase-3 (OR: 1.546, 95%CI: 1.183-2.022) and sFIT-1 levels (OR: 1.058, 95%CI: 1.015-1.104) were the prognostic factors in patients with sudden hearing loss (all P<0.05). ROC analysis results showed that the area under the curve (AUC) predicted by serum Caspase-3 combined with sFIt-1 was greater than that predicted by serum Caspase-3 and sFIt-1 alone. The sensitivity of joint prediction was 66.67%, the specificity was 87.72%, and the AUC was 0.819 (0.712-0.925); the sensitivity of Caspase-3 was 52.38%, the specificity was 82.46%, and the AUC was 0.721 (0.593-0.849); the sensitivity of FIT-1 was 52.38%, the specificity was 84.21%, and the AUC was 0.703 (0.573-0.832). Conclusions　Serum levels of Caspase-3 and sFIt-1 are significantly correlated with the degree of hearing loss and prognosis in patients with sudden hearing loss. Combined detection of these biomarkers can effectively predict the severity and prognosis of the disease, serving as biological indicators for evaluating the prognosis of this condition.

Key words:

Sudden hearing loss, Cysteine-aspartic protease-3, Soluble vascular endothelial growth factor receptor 1, Prognosis, Relationship