The Correlations Between The Glomerular Filtration Rate And The Clinical Characteristics And Prognosis Of Sudden Deafness

Objectives:To investigate the correlation between glomerular filtration rate(GFR)and sudden deafness,and to analyze the prognostic factors of sudden deafness,which has certain clinical and scientific value for the treatment and prevention of sudden deafness.Methods:(1)The cross-sectional design was used in this study,and the subjects were divided into sudden deafness group(261 patients with sudden deafness)and control group(102 patients with normal hearing),and the clinical data of the two groups were collected,to explore the risk factors of sudden deafness.(2)The sex,age,past history,estimated glomerular filtration rate(eGFR,because theGFR cannot be measured directly,the eGFR is commonly used in clinical practice)and three renal function items(serum creatinine,serum uric acid,blood urea nitrogen)were compared between sudden deafness group and control group,and to explore the risk factors for the development of sudden deafness.(3)The correlations between the eGFR,three renal function items and the clinical characteristics of sudden deafness were further explored.(4)The influencing factors of the prognosis of sudden deafness were analyzed by single-factor analysis,and the significant variables were analyzed by multi-factor logistic regression analysis.(5)After the eGFR was dichotomized(eGFR≤90 ml/min/1.73m~2 and eGFR>90 ml/min/1.73m~2),the clinical efficacy of sudden deafness was compared,and it is included in the logistic regression model to analyze its correlation with prognosis.(6)The ROC curve was plotted with eGFR as the indicator to study their predictive value in prognosis.Results:(1)The level of eGFR in the sudden deafness group was lower than that in the control group,and the level of Urea and the prevalence of diabetes were higher than those in the control group(P<0.05).(2)Hearing values(d B)of patients with sudden deafness were linearly and negatively correlated with the eGFR levels(P=0.02).(3)The level of eGFR was associated with gender,age,hypertension,diabetes,smoking and type of hearing loss of patients with sudden deafness(all P<0.05).(4)Multi-factor logistic regression analysis showed that the level of eGFR and hearing loss type were independent influencing factors for the prognosis of sudden deafness(P<0.05),and the treatment efficiency of the low frequency descending type is higher than that of the high frequency descending type,the flat descending type and the total deafness type.In addition,each 1 ml/min/1.73m~2increase in the eGFR,the possibility of effective prognosis increased by 1.038 times(OR=1.038,95%CI:1.016-1.061).The prognosis effective rate of sudden deafness with eGFR>90 ml/min/1.73m~2 is higher than that of patients with eGFR≤90ml/min/1.73m~2(5)The area under the ROC curve of the eGFR was 0.704(95%CI:0.642-0.766),and the prediction model was statistically significant(P<0.001),when the Youden index was 0.360,the optimal decision threshold was 103.50ml/min/1.73m~2.Conclusions:(1)A lower level of eGFR is a risk factor for the development of sudden deafness,and its level is related to the patient’s gender,age,history of hypertension,history of diabetes,history of smoking and type of hearing loss.(2)The level of eGFR and type of hearing loss are independent factors,influencing the prognosis of sudden deafness,and the higher the level of eGFR(cut-off value:103.50ml/min/1.73m~2),the better the prognosis.