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目的:探讨血清同型半胱氨酸(Hcy)、血浆D-二聚体(D-D)、血清高迁移率族蛋白1(HMGB1)与突发性聋的相关性。方法:选取2019年1—12月山西白求恩医院耳鼻咽喉头颈外科收治的113例突发性聋患者为突发性聋组，男54例，女59例，年龄(49.7±12.2)岁，年龄范围为18～80岁；另随机选取听力正常的138例同期健康体检者为健康组，男60例，女78例，年龄(49.6±12.1)岁，年龄范围为18～80岁。采用贝克曼AU5800全自动生化分析仪循环酶法测血清Hcy，ACL-TOP700全自动凝血分析仪免疫透射比浊法测血浆D-D，酶标仪酶联免疫吸附法测血清HMGB1，比较突发性聋组及健康组血清Hcy、血浆D-D、血清HMGB1水平；比较突发性聋组不同分型、分级及治疗效果的血清Hcy、血浆D-D、血清HMGB1水平及其相关性。结果:突发性聋组治疗前血清Hcy水平[(14.50±13.62)μmol/L]、血浆D-D水平[(144.12±137.22)μg/L]、血清HMGB1水平[(23.95±11.83)μg/L]均高于健康组[(9.52±3.73)μmol/L、(92.53±87.68)μg/L、(7.69±3.25)μg/L]，差异有统计学意义(n P<0.05)；突发性聋组治疗后血清Hcy水平[(8.47±4.69)μmol/L]、血浆D-D水平[(109.75±73.78)μg/L]、血清HMGB1水平[(15.45±7.72)μg/L]均低于治疗前，差异有统计学意义(n P<0.05)。治疗有效患者血清Hcy[(14.55±12.99)μmol/L]高于治疗无效患者[(8.45±5.87)μmol/L]，血浆D-D[(149.11±109.35)μg/L]高于治疗无效患者[(108.65±75.60)μg/L]，血清HMGB1[(25.35±13.93)μg/L]低于治疗无效患者[(34.45±15 33)μg/L]，差异有统计学意义(n P<0.05)。突发性聋的不同分型、分级、治疗效果与血清Hcy、血浆D-D、血清HMGB1水平间呈正相关性(n P<0.05)，其相关系数n r的范围为0.52～0.78，其中突发性聋患者的HMGB1水平与治疗效果的相关系数n r为0.78，两者呈强相关性。在辅助诊断突发性聋方面，Hcy诊断突发性聋的曲线下面积为0.925，D-D诊断突发性聋的曲线下面积为0.937。n 结论:高Hcy是突发性聋发病的危险因素，而D-D可即时反映突发性聋的凝血状态，HMGB1参与介导动脉血管损伤后炎症过程，对促进血管斑块形成，加重组织缺血起着关键作用。将Hcy、D-D、HMGB1控制在较低水平对研究突发性聋病因、防治及预后评估有重要临床意义，且D-D水平更为灵敏。“,”Objective:To investigate the correlation between homocysteine(Hcy), D-Dimer(D-D), high mobility group protein 1(HMGB1)and sudden sensorineural hearing loss(SSHL).Methods:A retrospective study was performed on 113 cases of patients with SSHL(SSHL group)who were admitted in the department of Otolaryngology & Head and Neck Surgery of Shanxi Bethune Hospital from January to December 2019, 54 males and 59 females, aged(49.7±12.2)years old, ranging 18~80 years old.In addition, 138 healthy patients with normal hearing were randomly selected as the health group, including 60 males and 78 females, aged(49.6±12.1)years old, ranging from 18 to 80 years old.The circulating enzyme method of Beckmann AU5800 automatic biochemical analyzer was used to measure serum Hcy, the immunoturbidimetric method of ACL-TOP700 Automatic Coagulation Analyzer was used to measure plasma D-D, the enzyme-linked immunosorbent assay was used to measure serum HMGB1.The Hcy, D-D and HMGB1 levels of the experimental group, the control group and the experimental group were compared in different types, different grades of the experimental group and different curative effects of the experimental group.The three indexes were analyzed in different fractions Correlation between groups.Results:Before treatment, the serum Hcy level[(14.50±13.62)μmol/L], plasma D-D level[(144.12±137.22)μg/L]and serum HMGB1 level[(23.95± 11.83)μg/L]of the SSHL group were all higher than those of the healthy group[(9.52±3.73)μg/L, (92.53±87.68)μg/L, (7.69± 3.25)μg/L], and the differences were statistically significant(n P<0.05). After treatment, serum Hcy level[(8.47±4.69)μmol/L], plasma D-D level[(109.75±73.78)μg/L]and serum HMGB1 level[(15.45±7.72)μg/L]in the SSHL group were all lower than before treatment(n P<0.05). Serum Hcy[(14.55±12.99)μmol/L)was higher than that of untreated patients[(8.45±5.87)μmol/L], plasma D-D[(149.11±109.35)μg/L]was higher than that of untreated patients[(108.65±75.60)μg/L], serum HMGB1[(25.35±13.93)μg/L]was lower than that of untreated patients[(34.45±15.33)μg/L], (n P<0.05). Different types, grades and therapeutic effects of sudden deafness were positively correlated with serum Hcy, plasma D-D and serum HMGB1 levels(n P<0.05), the correlation coefficientn r ranged from 0.52 to 0.78, among which the correlation coefficient n r between the level of HMGB1 in patients with sudden deafness and the therapeutic effect was 0.78, showing a strong correlation.In terms of auxiliary diagnosis of sudden deafness, the area under the curve of Hcy diagnosis of sudden deafness was 0.925, and the area under the curve of D-D diagnosis of sudden deafness was 0.937.n Conclusion:High Hcy is a risk factor for sudden deafness, and D-D can immediately reflect the coagulation state of sudden deafness.HMGB1 is involved in mediating the inflammatory process after arterial vascular injury, and plays a key role in promoting the formation of vascular plaques and aggravating tissue ischemia.The control of Hcy, D-D and HMGB1 at a lower level is of great clinical significance for the study of the etiology, prevention and treatment of sudden deafness and the evaluation of prognosis, and the D-D level is more sensitive.