子痫前期是否是耳蜗损伤和听力损失的新危险因素？

Department of Otolaryngology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.

Otol Neurotol. 2010 Oct;31(8):1180-3. doi: 10.1097/MAO.0b013e3181edb6eb.

OBJECTIVE

We investigated whether preeclampsia is a risk factor for cochlear damage and permanent hearing loss.

STUDY DESIGN

Prospective case-control study design.

SETTING

Academic tertiary medical center.

PATIENTS

Subjects included 40 patients with preeclampsia and 30 healthy pregnant women.

INTERVENTIONS

Otoscopic examinations and pure-tone audiometry, tympanometry, otoacoustic emissions (OAEs), and stapedial reflex tests were conducted for all subjects. Negative audiologic tests were reevaluated after the postpartum period. Statistical analyses were performed using χ and binary logistic regression testing.

MAIN OUTCOME MEASURES

We searched for signs of middle ear ventilation, damage of cochlea, and sensorineural hearing loss.

RESULTS

Eight patients from the preeclampsia group had 1 or more otological problems. Two patients from the control group were determined as having otological problems. Otoacoustic emissions of the right and left ears (p = 0.029, p = 0.044), hearing levels of right and left ear bone conduction (BC) at the 500-Hz frequency (right and left-BC 500), and left ear at the 2,000-Hz frequency (left-BC 2000) differed significantly between the preeclampsia and control groups (p = 0.040, p = 0.003, and p = 0.003). There was no significant difference in the OAEs between the right and left ears in the preeclampsia group (p < 0.05). The variables BC 500-left, BC 500-right, OAE-right, and OAE-left differed significantly between groups based on binary logistic testing. The odds ratio and 95% confidence intervals (95% CI) for these 4 risk variables were as follows: BC 500-left, 1.167 (1.044-1.306); BC 500-right, 1.117 (1.002-1.244); OAE-right, 0.642 (0.505-0.815); and OAE-left, 0.576 (0.475-0.698), respectively.

CONCLUSION

Preeclampsia is a risk factor for cochlear damage and permanent hearing loss. Even if preeclampsia resolves after delivery, cochlear damage and permanent hearing loss remain unchanged in patients with preeclampsia.

目的

探讨子痫前期是否是耳蜗损伤和永久性听力损失的危险因素。

研究设计

前瞻性病例对照研究设计。

地点

学术性三级医疗中心。

患者

研究对象包括 40 例子痫前期患者和 30 例健康孕妇。

干预措施

对所有受试者进行耳镜检查和纯音听阈测试、鼓室图测试、耳声发射（OAE）和镫骨肌反射测试。阴性听力学检查在产后进行复查。使用卡方检验和二项逻辑回归检验进行统计学分析。

主要观察指标

寻找中耳通气、耳蜗损伤和感觉神经性听力损失的迹象。

结果

子痫前期组 8 例患者存在 1 种或多种耳科问题。对照组 2 例患者确定存在耳科问题。右耳和左耳的 OAE（p=0.029，p=0.044）、右耳和左耳骨导 500Hz 听力水平（右骨导 500，p=0.040）、左耳 2000Hz 听力水平（左骨导 2000，p=0.003）在子痫前期组和对照组之间差异有统计学意义。OAE 右耳和左耳之间差异无统计学意义（p＜0.05）。根据二项逻辑检验，BC 500-左、BC 500-右、OAE-右和 OAE-左 4 个风险变量在组间差异有统计学意义。这 4 个风险变量的优势比和 95%置信区间（95%CI）分别为：BC 500-左，1.167（1.044-1.306）；BC 500-右，1.117（1.002-1.244）；OAE-右，0.642（0.505-0.815）；OAE-左，0.576（0.475-0.698）。