血清TRPV1、TIMP4、TGF-β1水平对良性阵发性位置性眩晕复发的预测价值

doi:10.11958/20241988

摘要/Abstract

摘要：

目的探究血清辣椒素受体1（TRPV1）、基质金属蛋白酶抑制剂4（TIMP4）、转化生长因子β1（TGF-β1）水平对良性阵发性位置性眩晕（BPPV）患者疾病复发的预测价值。方法选取BPPV患者326例为BPPV组，同期健康体检者357例为对照组；根据BPPV患者复位治疗1年后的复发情况分为未复发组（264例）和复发组（62例）。采用酶联免疫吸附试验检测患者血清TRPV1、TIMP4、TGF-β1水平。多因素Logistic回归分析BPPV患者复发的影响因素；受试者工作特征（ROC）曲线评估TRPV1、TIMP4、TGF-β1水平对BPPV患者复发的预测价值。结果 BPPV组血清TRPV1、TIMP4水平低于对照组，TGF-β1水平高于对照组（P<0.05）；复发组血清TRPV1、TIMP4水平低于未复发组，TGF-β1水平高于未复发组（P<0.05）。血清TRPV1、TIMP4水平降低，TGF-β1水平升高是BPPV患者复发的危险因素（P<0.05）。TRPV1、TIMP4、TGF-β1及三者联合预测BPPV患者复发的曲线下面积（AUC）分别为0.795（95%CI：0.748~0.838）、0.803（95%CI：0.756~0.845）、0.810（95%CI：0.764~0.851）和0.945（95%CI：0.914~0.967），三者联合检测对BPPV患者复发的预测价值优于单独预测。结论血清TRPV1、TIMP4、TGF-β1水平是BPPV患者复发的独立影响因素，三者联合对BPPV患者复发的预测价值更高。

关键词: 眩晕, TRPV阳离子通道, 基质金属蛋白酶抑制剂, 转化生长因子β1, 复发

Abstract:

Objective To explore the predictive value of serum levels of capsaicin receptor 1 (TRPV1), matrix metalloproteinase inhibitor 4 (TIMP4) and transforming growth factor beta 1 (TGF-β1) for disease recurrence in patients with benign paroxysmal positional vertigo (BPPV). Methods A total of 326 BPPV patients were selected and used as the BPPV group, and 357 healthy individuals who underwent physical examinations during the same period were selected and used as the control group. According to the recurrence status of BPPV patients after 1 year of reduction treatment, patients were divided into the non recurrence group (264 cases) and the recurrence group (62 cases). Enzyme linked immunosorbent assay was used to detect serum levels of TRPV1, TIMP4 and TGF-β1 in patients. Multivariate Logistic regression analysis was performed to analyze influencing factors of recurrence in BPPV patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of TRPV1, TIMP4, and TGF-1 levels for recurrence in BPPV patients. Results TRPV1 and TIMP4 were lower in the BPPV group than those in the control group, while TGF-β1 was higher than that in the control group (P<0.05). The TGF-β1 score in the recurrence group were higher than those in the non recurrence group, while TRPV1 and TIMP4 were lower than those in the non recurrence group (P<0.05). Serum TRPV1 and TIMP4 levels were lower in the recurrence group than those of the non recurrence group, and TGF-1 levels were higher in the recurrence group than those of the non recurrence group (P<0.05). The decreased serum levels of TRPV1 and TIMP4 were risk factors for recurrence in BPPV patients (P<0.05). The area under the curve (AUC) of TRPV1, TIMP4, TGF-β1 and their combined prediction of recurrence in BPPV patients were 0.795 (95%CI: 0.748-0.838), 0.803 (95%CI: 0.756-0.845), 0.810 (95%CI: 0.764-0.851) and 0.945 (95%CI: 0.914-0.967), respectively. The combined detection value of TRPV1, TIMP4 and TGF-β1 levels were better than that of single detection in predicting the recurrence in BPPV patients (all P<0.05). Conclusion The serum levels of TRPV1, TIMP4 and TGF-β1 are independent factors affecting the recurrence of BPPV patients, and the combination of the three has a higher predictive value for the recurrence of BPPV patients.

Key words: vertigo, TRPV cation channels, matrix metalloproteinase inhibitors, transforming growth factor beta1, recurrence

中图分类号:

R764.3

图/表 6

参考文献 20

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组别		n	性别（男/女）		年龄/岁		BMI/（kg/m²）		吸烟史
对照组		357	184/173		55.21±11.58		22.28±2.34		125（35.01）
BPPV组		326	162/164		54.56±10.87		22.21±2.25		132（40.49）
χ²或t			0.233		0.075		0.077		2.178
组别	饮酒史			TRPV1/（ng/L）		TIMP4/（ng/L）		TGF-β1/（ng/L）
对照组	104（29.13）			96.67±31.35		28.94±9.27		12.58±4.03
BPPV组	111（34.05）			79.72±24.73		23.71±7.82		17.32±5.46
χ²或t	1.910			8.093^＊		8.283^＊		13.308^＊

组别		n	性别（男/女）		年龄/岁		BMI/（kg/m²）		吸烟史
对照组		357	184/173		55.21±11.58		22.28±2.34		125（35.01）
BPPV组		326	162/164		54.56±10.87		22.21±2.25		132（40.49）
χ²或t			0.233		0.075		0.077		2.178
组别	饮酒史			TRPV1/（ng/L）		TIMP4/（ng/L）		TGF-β1/（ng/L）
对照组	104（29.13）			96.67±31.35		28.94±9.27		12.58±4.03
BPPV组	111（34.05）			79.72±24.73		23.71±7.82		17.32±5.46
χ²或t	1.910			8.093^＊		8.283^＊		13.308^＊

组别	n			性别（男/女）		年龄/岁			BMI/（kg/m²）			吸烟史
未复发组	264			127/137		54.26±10.84			22.17±2.21			105（39.77）
复发组	62			35/27		55.84±11.37			22.36±2.24			27（43.55）
χ²或t				1.399		1.023			1.574			0.297
组别		饮酒史			听力（正常/异常）			前庭功能（正常/异常）			耳鸣（是/否）
未复发组		87（32.95）			184/80			167/97			96/168
复发组		24（38.71）			38/24			32/30			28/34
χ²		0.741			1.633			2.863			1.649
组别			一次复位成功（是/否）				出现残余症状（是/否）			过度疲劳（是/否）
未复发组			193/71				82/182			142/122
复发组			41/21				25/37			39/23
χ²			1.207				1.953			1.689

组别	n			性别（男/女）		年龄/岁			BMI/（kg/m²）			吸烟史
未复发组	264			127/137		54.26±10.84			22.17±2.21			105（39.77）
复发组	62			35/27		55.84±11.37			22.36±2.24			27（43.55）
χ²或t				1.399		1.023			1.574			0.297
组别		饮酒史			听力（正常/异常）			前庭功能（正常/异常）			耳鸣（是/否）
未复发组		87（32.95）			184/80			167/97			96/168
复发组		24（38.71）			38/24			32/30			28/34
χ²		0.741			1.633			2.863			1.649
组别			一次复位成功（是/否）				出现残余症状（是/否）			过度疲劳（是/否）
未复发组			193/71				82/182			142/122
复发组			41/21				25/37			39/23
χ²			1.207				1.953			1.689

组别	n	TRPV1	TIMP4	TGF-β1
未复发组	264	84.26±27.12	25.14±7.68	16.37±4.37
复发组	62	60.37±18.64	17.62±5.43	21.36±6.85
χ²或t		7.703^＊	7.026^＊	6.246^＊