c反应蛋白(CRP)和耳漏作为坏死性外耳炎治疗反应的预后标志物:基于62例患者的回顾性队列研究

IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Acta Oto-Laryngologica Pub Date : 2025-01-01 Epub Date: 2024-12-08 DOI:10.1080/00016489.2024.2436088
Paul Zhaobo Liu, Dimitrios Spinos, Amr Allam, Patrick Long, Wai Sum Cho, Neil Fergie
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引用次数: 0

摘要

背景:坏死性外耳炎(NOE)治疗后复发率为15-20%。这主要是由于缺乏可靠的临床指标来解决疾病。目的:我们旨在评估62名患者治疗结果的耳痛、耳漏和c反应蛋白(CRP)水平的可预测性。方法:回顾性分析2017年1月至2020年6月在诺丁汉三级耳鼻喉科转诊单元连续接受NOE治疗的患者。根据临床表现和影像学诊断。对治疗的良好反应被定义为那些需要治疗不超过标准的六周的全身性抗生素。结果:平均发病年龄78.4岁。男性占75.8%。62.9%患有糖尿病。10名患者接受了超过标准6周的全身抗生素治疗。疾病进展的并发症包括颅神经病变(14.5%)、脑膜炎(3.2%)和乙状窦血栓形成(3.2%)。2例患者复发或持续NOE并在治疗期间死亡。CRP正常化延迟(p = 0.015)和耳漏消退延迟(p = 0.014)与延长抗生素治疗的需求增加相关。结论:c反应蛋白(CRP)的正常化和耳漏的消退有助于识别可能从长期全身抗生素治疗中获益的患者。
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C-reactive protein (CRP) and otorrhoea as prognosticate markers for necrotising otitis externa treatment response: based on a retrospective cohort study of 62 patients.

Background: Recurrence rate of necrotising otitis externa (NOE) after treatment is 15-20%. This is mainly due to a lack of reliable clinical indicator for the resolution of disease.

Aims: We aim to assess the predictability of the otalgia, otorrhoea and C-reactive protein (CRP) levels in a large cohort of sixty-two patients for treatment outcome.

Methods: Consecutive patients treated for NOE in our Nottingham tertiary ENT referral unit were retrospectively reviewed from January 2017 to June 2020. Diagnoses were made based on clinical findings and imaging. Good response to treatment was defined as those who required treatment of not longer than the standard six weeks of systemic antibiotics.

Results: Average age at presentation was 78.4 years. 75.8% of patients were male. 62.9% had diabetes. Ten patients received more than the standard six weeks of systemic antibiotics. Complications from disease progression included cranial nerve neuropathies (14.5%), meningitis (3.2%), and sigmoid sinus thrombosis (3.2%). Two patients had recurrent or persistent NOE and died while on treatment. Delays in normalization of CRP (p = 0.015) and resolution of otorrhoea (p = 0.014) were associated with an increased need for prolonged antibiotic treatment.

Conclusion: Normalisation of CRP and resolution of otorrhea can assist in identifying patients who will likely benefit from a prolonged course of systemic antibiotics.

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来源期刊
Acta Oto-Laryngologica
Acta Oto-Laryngologica 医学-耳鼻喉科学
CiteScore
2.50
自引率
0.00%
发文量
99
审稿时长
3-6 weeks
期刊介绍: Acta Oto-Laryngologica is a truly international journal for translational otolaryngology and head- and neck surgery. The journal presents cutting-edge papers on clinical practice, clinical research and basic sciences. Acta also bridges the gap between clinical and basic research.
期刊最新文献
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