【摘要】 目的:探讨血清抗内皮细胞抗体(AECA)对地塞米松治疗突发性聋(SHL)的疗效预测作用。方法:使用ELISA法检测48例SHL患者和30例正常对照者AECA,同时检测SHL患者治疗前后受损频率平均听阈,AECA阳性和阴性患者均给予10mg/d静脉地塞米松治疗5d,减量至5mg/d,5d后停药。比较AECA阳性和阴性突发性聋患者对地塞米松的治疗反应,对治疗前血清AECA水平与平均听阈改变进行相关性分析。结果:AECA阳性率在SHL组和正常对照组中分别为68.75%(33/48)和23.33%(7/30),差异有统计学意义(P<0.01)。AECA阳性及阴性SHL患者中分别有81.8%(27/33)和33.3%(5/15)对地塞米松治疗产生应答,差异有统计学意义(P<0.01)。治愈、显效、有效及无效在AECA阳性组分别为21.2%(7/33)、33.3%(11/33)、27.3%(9/33)和18.2%(6/33),而AECA阴性组则为0、13.3%(2/15)、20.0%(3/15)和66.7%(10/15),差异有统计学意义(P<0.01)。29例患者中除5例血清AECA浓度大于263μg/L外,其余听力恢复与血清AECA水平呈正相关(r=0.808 4,P<0.01)。结论:SHL患者血清AECA阳性率显著高于正常对照组,可以作为地塞米松治疗SHL的预后指标。更多还原

【Abstract】 Objective:To investigate relationship between anti-endothelial cell antibody(AECA) and response to dexamethasone in sudden hearing loss(SHL).Method:Forty-eight SHL patients and thirtynormal controls with SHL were recruited in present study.AECA was detected by ELISA in serum of all normal controls and SHL patients as well as pure-tone average was examined by electronic audiometry during treatmentin SHL patients.Both AECA-positive and-negative subjects received 10 mg/d venous dexamethasone for 5 days followed by gradual tapering of dose of 5 mg/d for another 5-day.Then pure-tone average was reexamined.Differences in hearing recovery between AECA-positive and-negative subjects and relationship between AECA level and hearing recovery were analyzed.Result:The prevalence of AECA detection was 68.75%(33 of 48 patients) in SHL patients,with significant difference compared with control subjects with 23.33%(7 of 30 controls)(P<0.01).After treatment,rates of response to dexamethasone in AECA-positive and-negative SHL patients were 81.8%(27 of 33 patients) and 33.3%(5 of 15 patients),respectively.Meanwhile,there was a significant difference in cure,excellent recovery,partly recovery and invalid between AECA-positive and-negative groups [(21.2%(7/33),33.3%(11/33),27.3%(9/33) and 18.2%(6/33) versus 0,13.3%(2/15),20.0%(3/15) and 66.7%(10/15),P<0.01].Except 5 subjects with AECA level more than 263 μg/L,hearing recovery was correlated to pretreatment AECA level(r=0.808 4,P<0.01).Conclusion:In sudden HL patients treated with dexamethasone,AECA might represent a serological marker of prognosis.更多还原