2型糖尿病患者血浆中PAI-1及sVCAM-1水平与耳鸣的相关性研究

目的探讨2型糖尿病(T2DM)患者血浆相关指标预测耳鸣发生情况的意义。方法对64例T2DM并发耳鸣患者及148例单纯T2DM患者临床资料进行回顾性分析,分别将其纳入观察组与对照组。比较两组患者血浆相关指标纤维酶原激活物抑制物-1(PAI-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、3-硝基酪氨酸(3-NT)、神经生长因子(NGF)水平,以受试者工作特征曲线(ROC曲线)分析上述指标单独或联合预测T2DM并发耳鸣的诊断效能,借助Pearson相关系数模型,探索观察组患者上述指标与耳鸣严重程度[耳鸣残疾度量化表(THI)]的相关性。结果观察组血浆PAI-1、sVCAM-1、3-NT、NGF水平均明显高于对照组,差异有统计学意义(P<0.05)。血浆PAI-1、sVCAM-1、3-NT、NGF单独预测T2DM患者并发耳鸣ROC曲线下面积(AUC)均大于0.5,Youden指数对应cut-off值分别为8.06 mmol/L、58.50 ng/mL、269.79 pg/mL、4.16 ng/mL;4个指标联合预测的ROC曲线AUC为0.796,均明显大于单独预测指标(P<0.05)。观察组患者血浆PAI-1、sVCAM-1、3-NT、NGF水平与THI评分均表现出显著正相关(r>0,P<0.05)。结论血浆PAI-1、sVCAM-1水平与T2DM患者并发耳鸣存在密切关系,可通过联合3-NT、NGF等指标开展较为准确的早期预测诊断,以期提高临床干预的目的性。

Correlation between plasma PAI-1 and sVCAM-1 levels and tinnitus in patients with type 2 diabetes mellitus

Objective To explore the significance of plasma-related indicators in predicting the occurrence of tinnitus of patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 64 patients with T2DM complicated with tinnitus and 148 patients with simple T2DM were retrospectively analyzed,and they were included in observation group and control group.Plasma-related indicators plasminogen activator inhibitor-1(PAI-1),soluble vascular cell adhesion molecule-1(sVCAM-1),3-nitrotyrosine(3-NT),nerve growth factor(NGF)were compared between the two groups,and the receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic efficacy of single or combination of the above indexes in predicting T2DM complicated with tinnitus.Pearson correlation coefficient model was used to explore the correlation between above indicators and severity of tinnitus[tinintus handicap inventory(THI)]in observation group.Results The levels of plasma PAI-1,sVCAM-1,3-NT and NGF in observation group were significantly higher than those in control group,the difference was statistically significant(P<0.05).The values of area under the ROC curve(AUC)of single plasma PAI-1,sVCAM-1,3-NT and NGF in predicting patients with T2DM complicated with tinnitus were all more than 0.5,and the cut-off values of Youden index were 8.06 mmol/L,58.50 ng/mL,269.79 pg/mL and 4.16 ng/mL respectively.The AUC of ROC curve of the combined prediction of four indexes was 0.796,which was significantly greater than that of single prediction index(P<0.05).The levels of plasma PAI-1,sVCAM-1,3-NT and NGF were significantly positively correlated with THI score in observation group(r>0,P<0.05).Conclusion The levels of plasma PAI-1 and sVCAM-1 are closely related to tinnitus in T2DM patients.It is possible to carry out more accurate early prediction and diagnosis by combining 3-NT and NGF to improve the clinical intervention.