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类风湿关节炎相关突发性聋的临床特点及预后。

Clinical Feature and Prognosis of Sudden Sensorineural Hearing Loss With Rheumatoid Arthritis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.

出版信息

Otol Neurotol. 2021 Mar 1;42(3):e267-e271. doi: 10.1097/MAO.0000000000002962.

Abstract

OBJECTIVES

Recent publications reported that patients with rheumatoid arthritis (RA) experience an increased risk of suffering sudden sensorineural hearing loss (SSNHL), however, these cases are poorly understood. This study aims to explore the clinical presentations and hearing recovery of SSNHL patients with RA.

STUDY DESIGN

Retrospective study.

SETTING

Tertiary medical center.

PATIENTS

Forty-seven SSNHL patients with RA (RA group) and 431 SSNHL patients without RA (non-RA group) were recruited between April 2015 and June 2019.

INTERVENTIONS

In the non-RA group, all patients were administrated with oral steroids. In the RA group, 21 patients were treated with oral steroid (OS group) and 26 patients were administrated with intratympanic steroids plus oral steroids (IS+OS group).

MAIN OUTCOME MEASURES

We explored the clinical features and hearing recovery of SSNHL patients with RA in comparison with patients without RA, we also evaluated the therapeutic effect of combined steroids in SSNHL patients with RA.

RESULTS

RA group had higher initial hearing loss level (mean 68.5 dB), final hearing threshold (mean 52.3 dB), the rates of profound hearing loss (48.9%), and no recovery (48.9%) than non-RA group (mean 55.1 dB, mean 34.8 dB, 32.9 and 27.6%, all p < 0.05), however, had lower hearing gains (mean 16.1 dB) and the rate of partial recovery (12.8%) than non-RA group (mean 20.3 dB and 28.8%, all p < 0.05). Furthermore, IS+OS group had higher hearing gains (mean 21.1 dB) and lower rate of no recovery (30.8%) than in the OS group (mean 10.0 dB and 71.4%, all p < 0.05).

CONCLUSIONS

SSNHL patients with RA experienced severe hearing loss and had poor hearing prognosis. IS+OS provide better hearing recovery than OS for this population.

摘要

目的

最近的出版物报道称,类风湿关节炎(RA)患者发生突发性感觉神经性听力损失(SSNHL)的风险增加,然而,这些病例尚不清楚。本研究旨在探讨 RA 患者 SSNHL 的临床表现和听力恢复情况。

研究设计

回顾性研究。

设置

三级医疗中心。

患者

2015 年 4 月至 2019 年 6 月期间共招募了 47 例 SSNHL 合并 RA 患者(RA 组)和 431 例 SSNHL 不合并 RA 患者(非 RA 组)。

干预措施

在非 RA 组中,所有患者均给予口服类固醇治疗。在 RA 组中,21 例患者接受口服类固醇(OS 组)治疗,26 例患者接受鼓室内类固醇联合口服类固醇(IS+OS 组)治疗。

主要观察指标

比较 RA 组与非 RA 组 SSNHL 患者的临床特征和听力恢复情况,评估联合类固醇治疗 RA 合并 SSNHL 患者的疗效。

结果

RA 组初始听力损失水平(平均 68.5dB)、最终听力阈值(平均 52.3dB)、重度听力损失率(48.9%)和无恢复率(48.9%)均高于非 RA 组(平均 55.1dB、平均 34.8dB、32.9%和 27.6%,均 P<0.05),但听力提高程度(平均 16.1dB)和部分恢复率(12.8%)低于非 RA 组(平均 20.3dB 和 28.8%,均 P<0.05)。此外,IS+OS 组的听力提高程度(平均 21.1dB)和无恢复率(30.8%)均高于 OS 组(平均 10.0dB 和 71.4%,均 P<0.05)。

结论

RA 合并 SSNHL 患者听力损失严重,听力预后较差。IS+OS 为该人群提供了比 OS 更好的听力恢复效果。

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