Correlation Analysis Of Peripheral Blood Inflammation,Hemostatic Parameters With The Pathogenesis And Prognosis Of Refractory Sudden Sensorineural Hearing Loss

Objective:To explore the correlation of peripheral blood inflammation and hemostatic parameters in the diagnosis and prognosis of refractory sudden sensorineural hearing loss(RSSNHL).Methods:This study systematically reviewed the clinical data of 1018 patients with SSNHL treated in our hospital from 2012 to 2022.After screening,we selected 134 patients diagnosed with RSSNHL,238 diagnosed patients with NRSSNHL(Non-refractory Sudden Sensorineural Hearing Loss)and 1156 cases in the control group.Comparison of clinical features and hematological parameters between SSNHL(Sudden Sensorineural Hearing Loss)and different SSNHL groups.Including inflammatory markers(such as neutrophil count,lymphocyte count,monocyte count,neutrophil-lymphocyte ratio(NLR),monocyte-lymphocyte ratio(MLR)and platelet-lymphocyte ratio(PLR))and hemostatic parameters(including platelet count,mean platelet volume(MPV),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen).Univariate and multivariate Logistic regression analysis was used to explore the relationship between hematological parameters and clinical variables and NRSSNHL,RSSNHL,SSNHL.Results:In RSSNHL group,we observed older age(45.75±14.10 years old,vs 41.87±15.46 years old,P<0.05),higher incidence of right ear(56.7%vs 43.7%P<0.05),more vertigo symptoms(47.8%vs 21.0%P<0.05),higher blood glucose(6.66±3.25 mmol/L vs 5.79±1.79 mmol/L,P<0.05)and poorer treatment effect(6.7%vs 63.9%P<0.05).Compared with NRSSNHL,there was no statistical difference in blood inflammation and hemostatic parameters.Logistic regression analysis showed that age,side,pure tone audiometry before treatment,hearing curve type,vertigo and blood glucose were risk factors for RSSNHL,but only pure tone audiometry before treatment was an independent risk factor for RSSNHL.The neutrophil count(6.33±2.94 G/L),monocyte count(0.50±0.38 G/L),NLR(3.90±2.44),MLR(0.26±0.22)and PLR(150.10±78.73)in the SSNHL group were higher than those in the control group(3.70 ± 1.29 G/L,0.39±0.13 G/L,1.83±0.76,0.19±0.07,124.62 ±41.44).The lymphocyte count(1.96±0.96 G/L)in the control group(2.14±0.63 G/L)was lower than that in the control group(P<0.01).Using these parameters,the ROC curve was drawn and the optimal critical values were obtained:NLR(>2.844),MLR(>0.2405)and PLR(>170.7),neutrophil count(>4.645 G/L),monocyte count(>0.5550 G/L)and lymphocyte count(<1.385 g/L).Lymphocyte count<1.385 G/L,age and sex were considered as independent protective factors of SSNHL(OR<1),while neutrophil count>4.645 G/L,monocyte count>0.5550 G/L,NLR>2.844,mean platelet volume>10.25 fL and blood glucose were considered as independent risk factors for SSNHL(OR>1).Conclusion:Through the retrospective study of 372 patients with SSNHL,we found that peripheral inflammatory markers and specific clinical data(including neutrophil count>4.645G/L,blood glucose level,MPV>10.25fL,lymphocyte count<1.385G/L,monocyte count>0.555 G/L NLR>2.844,age and sex)were important independent predictors of SSNHL,which provided more accurate information for further prevention of SSNHL.There was no significant difference in peripheral blood inflammation and hemostatic parameters between NRSSNHL and RSSNHL groups.The increase of pure tone audiometry before treatment was an important independent risk factor for RSSNHL.