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评价异维 A 酸口服制剂对寻常型痤疮患者听觉系统的影响:可逆还是不可逆?

Evaluation of oral isotretinoin effects on hearing system in patients with acne vulgaris: Reversible or not?

机构信息

Department of Dermatology, Aksaray University Faculty of Medicine, Aksaray, Turkey.

Department of Otolaryngology, Aksaray University Faculty of Medicine, Aksaray, Turkey.

出版信息

Dermatol Ther. 2021 Jan;34(1):e14640. doi: 10.1111/dth.14640. Epub 2020 Dec 10.

Abstract

Systemic isotretinoin is commonly used for severe acne treatment. It has many side effects, one of these is about hearing system, which has rarely been reported, also previous studies reported contradictory results about systemic isotretinoin and its association with hearing system. In this study, we aimed to investigate whether systemic isotretinoin affected on the hearing system or not. The study included 32 acne vulgaris patients (64 ears) who treated with oral isotretinoin 0.5 mg/kg body weight for at least 4 months and audiometric tests including pure-tone, speech, bilateral acoustic reflexes, and tympanometric measurements were performed at baseline, in the first week, in the first month, and third month of treatment, and sixth month after treatment. Audiometric tests were performed for right and left ears separately. A significant difference was found in the pure-tone thresholds (before treatment, first week, first month, third month of treatment, and sixth month after treatment) for the both ears at 8000 Hz (P < .001) and a significant decrease in the sixth month post-treatment pure-tone thresholds compared to pre-treatment thresholds at 8000 Hz. Additionally, a statistically significant increase was observed in serum LDL and triglyceride levels in the third month of treatment and a significant decrease at the sixth month after treatment (P < .001). Systemic isotretinoin caused bilateral hearing threshold changes in acne patients during the therapy but the changes improved after discontinuation. Therefore, our findings may provide safety using for dermatologists about hearing effects of isotretinoin, which is quite effective on severe acne.

摘要

系统用异维 A 酸通常用于严重痤疮的治疗。它有许多副作用,其中之一是关于听觉系统,这很少被报道,也有以前的研究报告说系统用异维 A 酸及其与听觉系统的关系结果是相互矛盾的。在这项研究中,我们旨在研究系统用异维 A 酸是否对听觉系统有影响。该研究包括 32 例寻常痤疮患者(64 耳),他们接受了至少 4 个月的口服异维 A 酸 0.5mg/kg 体重治疗,并在基线、治疗第 1 周、第 1 个月、第 3 个月和治疗后第 6 个月进行了纯音、言语、双侧声反射和鼓室测量的听力学测试,听力学测试分别在右耳和左耳进行。在 8000Hz 时,双耳的纯音阈值(治疗前、治疗第 1 周、第 1 个月、第 3 个月和治疗后第 6 个月)差异有统计学意义(P<.001),且治疗后第 6 个月的纯音阈值与治疗前相比明显下降(P<.001)。此外,在治疗的第 3 个月,血清 LDL 和甘油三酯水平显著升高,在治疗后第 6 个月显著下降(P<.001)。系统用异维 A 酸在治疗期间导致痤疮患者双侧听力阈值变化,但停药后这些变化得到改善。因此,我们的研究结果可能为皮肤科医生提供关于异维 A 酸的听力影响的安全性信息,因为异维 A 酸对严重痤疮非常有效。

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