Ballesteros F, Tassies D, Reverter J C, Alobid I, Bernal-Sprekelsen M
Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Clínic, Barcelona, Spain.
Audiol Neurootol. 2012;17(6):400-8. doi: 10.1159/000341989. Epub 2012 Aug 30.
The main causative process in idiopathic sudden sensorineural hearing loss (iSSNHL) has yet to be explained or demonstrated. The clinical picture supports vascular involvement, but obvious limitations of inner ear study make this difficult to corroborate.
To determine the role of thrombophilic genetic variants that may affect platelet function and to assess the cardiovascular risk profile in a cohort of patients with iSSNHL.
118 Caucasian patients with iSSNHL were recruited from the same geographical area and enrolled prospectively in this study. Clinical data were obtained for each patient. Polymorphisms of the platelet glycoprotein subunit IIIa gene, ITGB3 (PLA1/A2, rs5918), and of the platelet glycoprotein subunit Ia gene, ITGA2 (C807T, rs1126643) were analyzed. A control group of 161 age- and gender-matched healthy individuals from the same geographical area was recruited for genetic comparisons. In order to determine the cardiovascular risk profile of each patient and of our cohort, a cross-sectional assessment was performed by means of a calibrated Framingham coronary heart disease risk scale. Risk factor proportions were compared to those recommended in European guidelines for coronary prevention, which are also based on the Framingham function.
A significantly high prevalence of the 807T allele of platelet glycoprotein subunit Ia was found in patients compared to controls. There was a significant correlation between the 807TT homozygous genotype and a low probability of recovery. The PLA1/A2 polymorphism of platelet glycoprotein subunit IIIa was not associated with recovery, with a similar genotype prevalence being found in patients and controls. In terms of cardiovascular risk profile, patients did not present an excess of baseline coronary risk factors compared to the general population in the same geographical area.
Patients with iSSNHL had a higher prevalence of the 807T thrombophilic polymorphism of platelet glycoprotein Ia/IIa. Patients homozygous for this polymorphism are less likely to recover from iSSNHL. Classical cardiovascular risk factors were not related to iSSNHL.
特发性突发性感音神经性听力损失（iSSNHL）的主要致病过程尚未得到解释或证实。临床表现支持血管受累，但内耳研究存在明显局限性，难以证实这一点。
确定可能影响血小板功能的血栓形成相关基因变异的作用，并评估一组iSSNHL患者的心血管风险状况。
从同一地理区域招募了118名白种人iSSNHL患者，并前瞻性纳入本研究。获取了每位患者的临床数据。分析了血小板糖蛋白亚基IIIa基因ITGB3（PLA1/A2，rs5918）和血小板糖蛋白亚基Ia基因ITGA2（C807T，rs1126643）的多态性。从同一地理区域招募了161名年龄和性别匹配的健康个体作为对照组进行基因比较。为了确定每位患者及我们队列的心血管风险状况，通过校准的弗明汉姆冠心病风险量表进行了横断面评估。将风险因素比例与欧洲冠心病预防指南中推荐的比例进行比较，该指南也是基于弗明汉姆函数制定的。
与对照组相比，患者中血小板糖蛋白亚基Ia的807T等位基因患病率显著较高。807TT纯合基因型与恢复概率低之间存在显著相关性。血小板糖蛋白亚基IIIa的PLA1/A2多态性与恢复无关，患者和对照组的基因型患病率相似。在心血管风险状况方面，与同一地理区域的普通人群相比，患者的基线冠心病风险因素并未过多。
iSSNHL患者血小板糖蛋白Ia/IIa的807T血栓形成多态性患病率较高。该多态性纯合的患者从iSSNHL中恢复的可能性较小。经典心血管风险因素与iSSNHL无关。
