Badfar Gholamreza, Mansouri Akram, Shohani Masoumeh, Karimi Hamid, Khalighi Zahra, Rahmati Shoboo, Delpisheh Ali, Veisani Yousef, Soleymani Ali, Azami Milad
Department of Pediatrics, Behbahan Faculty of Medical Sciences, Behbahan, Iran.
Nursing Care Research Center in Chronic Disease, School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.
Caspian J Intern Med. 2017 Fall;8(4):239-249. doi: 10.22088/cjim.8.4.239.
Hearing disorders are reported in thalassemia patients treated with deferoxamine. This study aimed to assess hearing loss in Iranian thalassemia major patients treated with deferoxamine.
This review article was designed based on PRISMA guidelines. To review the literature, two researchers studied national and international databases including Iranmedex, Magiran, Medlib, SID, Scopus, PubMed, Science Direct, Web of Science and Google Scholar without time limit until May 2017. Cochran's Q test and I index were used to assess the heterogeneity of the studies. The data were analyzed using Comprehensive Meta-Analysis software version 2 and p<0.05 was considered significant.
A total of 17 articles involving 1,835 Iranian thalassemia major patients treated with deferoxamine were included in the meta-analysis. The overall prevalence of hearing loss was estimated 27.3% (95% confidence intervals (CI): 19-37.6). The prevalence of sensorineural, conductive and mixed hearing loss was estimated 10.6% (95% CI: 5.7-18.8), 14.6% (95% CI: 10.5-20.6) and 9.1% (95% CI: 5.6-14.6), respectively. No significant differences were noted regarding the relationship hearing loss and mean serum ferritin (P=0.29) and average daily deferoxamine (P=0.30). Meta-regression model showed an increased significance in the prevalence of hearing loss based on the year of studies (p<0.0001).
There is a high prevalence of hearing loss in Iranian thalassemia major patients treated with deferoxamine. Therefore, periodic hearing assessments and regular check-ups after the initiation of chelation therapy are necessary.
有报道称接受去铁胺治疗的地中海贫血患者存在听力障碍。本研究旨在评估接受去铁胺治疗的伊朗重型地中海贫血患者的听力损失情况。
本综述文章是根据PRISMA指南设计的。为了回顾文献，两名研究人员研究了包括Iranmedex、Magiran、Medlib、SID、Scopus、PubMed、Science Direct、Web of Science和Google Scholar在内的国内外数据库，时间不限，直至2017年5月。采用Cochran's Q检验和I指数评估研究的异质性。使用综合Meta分析软件2.0版对数据进行分析，p<0.05被认为具有统计学意义。
共有17篇文章纳入荟萃分析，涉及1835例接受去铁胺治疗的伊朗重型地中海贫血患者。听力损失的总体患病率估计为27.3%（95%置信区间（CI）：19-37.6）。感音神经性、传导性和混合性听力损失的患病率分别估计为10.6%（95%CI：5.7-18.8）、14.6%（95%CI：10.5-20.6）和9.1%（95%CI：5.6-14.6）。在听力损失与平均血清铁蛋白（P=0.29）和平均每日去铁胺剂量（P=0.30）之间未发现显著差异。Meta回归模型显示，根据研究年份，听力损失患病率的显著性增加（p<0.0001）。
接受去铁胺治疗的伊朗重型地中海贫血患者听力损失患病率较高。因此，在开始螯合治疗后进行定期听力评估和定期检查是必要的。
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