Analysis Of The Correlation Between Inflammatory Indicators,Ecochg,ABR And Prognosis In Patients With Sudden Hearing Loss

Objective: To conduct a retrospective study by analyzing the relevant inflammatory indexes,-SP/AP values in electrocochleography(EcochG),and auditory brainstem responses(ABR)in patients with sudden hearing loss,to analyze the relationship between the relevant factors and the prognosis of patients with sudden hearing loss,to explore the etiology and pathogenesis of sudden hearing loss,and to provide new clinical ideas for the diagnosis and treatment of sudden hearing loss and prediction of treatment outcome.Methods: A total of 195 patients with sudden hearing loss admitted to the ear department of The First Hospital of Qinhuangdao from January2021 to January 2022 were collected.After screening according to exclusion criteria,a total of 184 patients were included in this study.All patients with sudden hearing loss were diagnosed and treated during their hospitalization in accordance with the Guidelines for the Diagnosis and Treatment of Sudden hearing loss(2015).The results of the first EcochG and ABR were recorded after the patients were admitted to hospital.Peripheral blood was collected within 24 hours of admission for routine blood tests to record the white blood cell count,neutrophil count,monocyte count,lymphocyte count and platelet count,and to calculate and record the results of the compliance parameters,include Neutrophil-to-lymphocyte ratio(NLR),Monocyte-to-lymphocyte ratio(MLR),Platelet-to-lymphocyte ratio(PLR),and Systemic immune inflammation index(SII).The results of pure tone audiometry before and after treatment were used to evaluate the efficacy of the treatment and group the patients.All data were imported into Excel to create a database and then analyzed in SPSS25.0 statistical software.The monocyte count and neutrophil count were normally distributed,and the independent samples t-test was used to examine their association with the efficacy of sudden hearing loss.The remaining inflammatory indicators were analyzed for correlation using the Mann-Whitney U rank sum test.Age,gender,lateralization of the affected ear,type of hearing curve,degree of hearing loss,EcochG,and ABR were analyzed for prognostic correlation using the chi-square test.Binary logistic regression was used to analyze the correlation between the relevant factors and the prognosis of sudden hearing loss.The ROC curves were plotted and the effectiveness of the combination of multiple indicators in predicting the prognosis of sudden hearing loss was evaluated using three scores: area under the ROC curve,sensitivity and specificity.RESULTS: The analysis of variance concluded that(1)between the total effective group(the total effective group was the sum of the healed、significant、 effective groups)and the invalid group,the differences in age,course of treatment,side of the affected ear,type of hearing,-SP/AP values in EcochG and ABR results were statistically significant between the two groups(P<0.05).(2)In the relevant inflammatory indexes,the differences in the levels of NLR,MLR,PLR,and SII were statistically significant between the total effective and ineffective groups(P<0.05).(3)All variables that met the requirements in the univariate analysis were entered into a binary logistic regression analysis: patients with sudden hearing loss older than 55 years have an increased risk of poor prognosis(P=0.016,OR=0.340,95%CI:0.142-0.815);patients who have sudden hearing loss in the right ear have a better prognosis than those who have the disease in the left ear.(P=0.008,OR=2.506,95%CI:1.266-4.959);there was a significant difference in the comparison of outcomes between patients with sudden hearing loss in the EcochG-SP/AP<0.4 and unprimed groups(P=0.005,OR=0.316,95%CI:0.141-0.709);for every unit increase in MLR,the likelihood of an effective prognosis for sudden hearing loss decreases(P= 0.016,OR=0.019,95%CI:0.001-0.486);for every unit increase in the PLR,the likelihood of an effective prognosis for sudden hearing loss decreases(P=0.021,OR=0.993,95%CI:0.988-0.999).Conclusions:1.Patients with sudden hearing loss aged ≥55 years have a poor prognosis;patients with sudden hearing loss in the right ear had a better prognosis than those in the left ear.2.The prognosis of patients with different types of sudden hearing loss did not correlate with the results of EcochG,although-SP/AP was not elicited as a risk factor for the prognosis of sudden hearing loss.3.Abnormal ABR results may indicate a poor prognosis for patients with sudden hearing loss.4.There were no significant differences in NLR,MLR,PLR and SII values between the different hearing curve types of patients with sudden hearing loss.The higher the MLR and PLR values,the worse the prognosis of sudden hearing loss,which can be used as a predictor of prognosis.The high MLR and PLR values reflect the high level of inflammation in the body and suggest that inflammation is closely related to the development of sudden hearing loss.5.The sensitivity of the combination of multiple indicators to predict the prognosis of sudden hearing loss was 69.86% and the specificity was74.77%.