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镰状细胞贫血患者听觉系统功能障碍:系统评价与荟萃分析。

Dysfunction of the auditory system in sickle cell anaemia: a systematic review with meta-analysis.

机构信息

Postgraduate Course in Medicine and Human Health, Bahiana School of Medicine and Public Health, Salvador, Brazil.

College of Speech Therapy, State University of Bahia, Cabula, Brazil.

出版信息

Trop Med Int Health. 2019 Nov;24(11):1264-1276. doi: 10.1111/tmi.13307. Epub 2019 Oct 7.

Abstract

OBJECTIVES

To describe the occurrence of both peripheral and central auditory system dysfunction in sickle cell anaemia (SCA) patients and discuss the different mechanisms hypothesised to be responsible for these alterations.

METHODS

An electronic search was conducted using PubMed Central (MEDLINE), LILACS and Scopus databases. This systematic review was performed in accordance with the PRISMA statement. Original observational studies that utilised audiological tests for auditory system evaluations in SCA were included.

RESULTS

A total of 183 records were found in the databases searched. Twenty-one of these studies met the inclusion criteria. Pooled prevalence of sensorineural hearing loss (SNHL) was 20.5% (CI: 10.3-33%). Retrocochlear involvement was detected with the auditory brainstem response, which assesses integrity of the cochlea, 8th cranial nerve and brainstem structures. In addition, the increase in otoacoustic emission amplitudes in SCA patients indicates changes in cochlear micromechanics and precedes the expression of a detectable cochlear pathology.

CONCLUSION

The prevalence of the SNHL is higher than in the general population. Dysfunction of the auditory system may be present in SCA patients, with the most probable mechanism being the presence of circulatory disturbances resulting from the chronic inflammatory state of the disease.

摘要

目的

描述镰状细胞贫血(SCA)患者外周和中枢听觉系统功能障碍的发生情况,并讨论导致这些改变的不同机制假说。

方法

使用 PubMed Central(MEDLINE)、LILACS 和 Scopus 数据库进行电子检索。本系统评价按照 PRISMA 声明进行。纳入了使用听觉测试评估 SCA 患者听觉系统的原始观察性研究。

结果

在搜索的数据库中发现了 183 条记录。其中 21 项研究符合纳入标准。感觉神经性听力损失(SNHL)的综合患病率为 20.5%(CI:10.3-33%)。通过评估耳蜗、第 8 颅神经和脑干结构完整性的听觉脑干反应检测到了耳蜗后受累。此外,SCA 患者的耳声发射幅度增加表明耳蜗微力学发生变化,且先于可检测到的耳蜗病理学出现。

结论

SNHL 的患病率高于一般人群。听觉系统功能障碍可能存在于 SCA 患者中,最可能的机制是疾病的慢性炎症状态导致循环紊乱。

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