Chiu Chong-Chi, Lee Kuan-Ji, Weng Shih-Feng, Yang Yuan-Ming, Lin Yung-Song
Department of General Surgery, Chi Mei Medical Center, Tainan and Liouying, Taiwan Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
Department of Otolaryngology, Chi Mei Medical Center, Tainan City, Taiwan.
BMJ Open. 2015 Sep 29;5(9):e009018. doi: 10.1136/bmjopen-2015-009018.
This study aims to test the hypothesis that gallstone disease (GSD) is a risk factor for the development of idiopathic sudden sensorineural hearing loss (ISSNHL). Research has shown risks of cardiovascular and cerebrovascular events in patients with GSD; however, well-conducted English studies on the association between GSD and the development of ISSNHL are lacking.
Retrospective cohort study using the Taiwan Longitudinal Health Insurance Database.
We compared 26,449 patients diagnosed with GSD between 1 January 2001 and 31 December 2007, with 52,898 age-matched, gender-matched and comorbidities propensity scores-matched controls.
We followed each patient until the end of 2011 and evaluated the incidence of ISSNHL for at least 4 years after the initial GSD diagnosis.
The incidence of ISSNHL was 1.42 times higher in the GS cohort than in the non-GS cohort (9.27 vs 6.52/10,000 person-years). Using Cox proportional hazard regressions, the adjusted HR was 1.44 (95% CI 1.19 to 1.74). In the cohort of patients with GSD who needed a cholecystectomy, 37 patients suffered from ISSNHL. Among those patients, 31 (83.7%) patients sustained ISSNHL before cholecystectomy and 6 (16.2%) patients sustained ISSNHL after cholecystectomy.
A diagnosis of GSD may be an independent risk for ISSNHL. This finding suggests that an underlying vascular and inflammatory mechanism may contribute to the development of ISSNHL. Physicians may want to counsel patients with GSD to seek medical attention if they have hearing impairments, because patients may be at an increased risk of developing ISSNHL.
本研究旨在验证胆结石病（GSD）是特发性突发性感音神经性听力损失（ISSNHL）发生的危险因素这一假设。研究表明，GSD患者存在心血管和脑血管事件风险；然而，缺乏关于GSD与ISSNHL发生之间关联的高质量英文研究。
使用台湾纵向健康保险数据库进行回顾性队列研究。
我们比较了2001年1月1日至2007年12月31日期间诊断为GSD的26449例患者与52898例年龄、性别匹配且合并症倾向评分匹配的对照。
我们对每位患者进行随访至2011年底，并评估初次诊断GSD后至少4年的ISSNHL发病率。
胆结石队列中ISSNHL的发病率比非胆结石队列高1.42倍（9.27 vs 6.52/10000人年）。使用Cox比例风险回归分析，校正后的风险比为1.44（95%置信区间1.19至1.74）。在需要进行胆囊切除术的GSD患者队列中，有37例患者患有ISSNHL。在这些患者中，31例（83.7%）在胆囊切除术前发生ISSNHL，6例（16.2%）在胆囊切除术后发生ISSNHL。
GSD诊断可能是ISSNHL的独立危险因素。这一发现表明，潜在的血管和炎症机制可能促使ISSNHL的发生。医生可能需要建议GSD患者，如果出现听力障碍应寻求医疗关注，因为这些患者发生ISSNHL的风险可能会增加。
