前庭神经炎患者血清免疫炎症指标和25-羟维生素D水平变化及意义

Changes and Significance of Serum Immunoinflammatory Indexes and 25-hydroxyvitamin D Levels in Patients with Vestibular Neuritis

摘要

目的 探讨前庭神经炎患者血清免疫炎症指标和25-羟维生素D（25-OH-D）水平变化及意义。方法 选取2021年6月~2023年6月河南省直第三人民医院收治的120例前庭神神经炎患者,将其作为研究组,同时选择同期于本院进行体检的100例无眩晕或无平衡障碍疾病的健康人群,将其作为参照组,进行前瞻性研究。采集2组研究对象基线资料,检测血清免疫炎症指标、25-OH-D水平并对比,采用多因素二元Logistic回归分析前庭神经炎发生的危险因素,采用Pearson相关软件分析血清25-OH-D水平与免疫炎症指标的相关性。结果 2组研究对象年龄、性别、体质量指数等基线资料进行对比,均无明显差异（均P>0.05）;研究组患者中性粒细胞/淋巴细胞比值（NLR）、C-反应蛋白（CRP）、CD8⁺百分比相较于参照组升高,25-OH-D、CD3⁺、CD4⁺百分比及CD4⁺/CD8⁺比值相较于参照组下降（均P<0.05）,而2组研究对象总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）比较,差异均无统计学意义（均P>0.05）;多因素二元Logistic回归分析结果显示,25-OH-D、CRP均为前庭神经炎发生的独立危险因素（OR=1.125、1.234,均P<0.05）;Pearson相关软件分析,前庭神经炎患者血清25-OH-D水平与CD4⁺/CD8⁺之间呈正相关（r=0.518,P<0.05）,而与CRP之间呈负相关（r=-2.219,P<0.05）。结论 前庭神经炎患者的血清25-OH-D水平相较于参照组显著下降,25-OH-D、CRP均为前庭神经炎发生的独立危险因素,且前庭神经炎患者血清25-OH-D水平与CD4⁺/CD8⁺之间呈正相关,而与CRP之间呈负相关,对前庭神经炎患者进行维生素D的补充治疗可作为该疾病治疗的新靶点。

Abstract

Objective To investigate the changes and significance of serum immunoinflammatory indexes and 25-hydroxyvitamin D (25-OH-D) levels in patients with vestibular neuritis. Methods A total of 120 patients with vestibular neuritis admitted to the Third People's Hospital of Henan Province from June 2021 to June 2023 were selected as the study group, and 100 healthy people without vertigo or balance disorder who underwent physical examination in the same period were selected as the reference group to conduct a prospective study. Baseline data of the two groups of subjects were collected, serum immunoinflammatory indicators and 25-OH-D levels were detected and compared. Multivariate binary Logistic regression was used to analyze the risk factors of vestibular neuritis, and Pearson related software was used to analyze the correlation between serum 25-OH-D levels and immunoinflammatory indicators. Results There were no significant differences in age, sex and body mass index between the two groups (all P>0.05). Neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and CD8⁺ percentage were increased, while 25-OH-D, CD3⁺, CD4⁺ percentage and CD4⁺/CD8⁺ ratio were decreased in study group compared with reference group (all P<0.05). There were no significant differences in total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), immunoglobulin A (IgA), immunoglobulin M (IgM) and immunoglobulin G (IgG) between 2 groups (all P>0.05). Multivariate Logistic regression analysis showed that 25-OH-D and CRP were independent risk factors for vestibular neuritis (OR =1.125, 1.234, P<0.05). According to Pearson analysis, serum 25-OH-D level in vestibular neuritis patients was positively correlated with CD4⁺/CD8⁺ (r=0.518, P<0.05), but negatively correlated with CRP (r=-2.219, P<0.05). Conclusion Serum 25-OH-D level in patients with vestibular neuritis was significantly decreased compared with the control group. Both 25-OH-D and CRP were independent risk factors for vestibular neuritis, and serum 25-OH-D level in patients with vestibular neuritis was positively correlated with CD4⁺/CD8⁺, while negatively correlated with CRP. Vitamin D supplementation in patients with vestibular neuritis may be a new target for the treatment of this disease.

关键词

前庭神经炎 / 免疫炎症指标 / 25-羟维生素D

Key words

Vestibular neuritis / Immunoinflammatory index / 25-hydroxyvitamin D

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