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[类风湿关节炎伴发突发性感音神经性听力损失的临床特征与预后]

[Clinical characteristics and prognosis of sudden sensorineural hearing loss with rheumatoid arthritis].

作者信息

Wang Gang, Deng Guoqing, Liang Juntao, Zhao Zhibin

机构信息

Department of Otolaryngology Head and Neck Surgery,Hainan People's Hospital,Hainan Hospital Affiliated of Hainan Medical University,Haikou,570311,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jan 5;35(1):9-13. doi: 10.13201/j.issn.2096-7993.2021.01.002.

Abstract

To analyze the clinical features and prognosis of sudden sensorineural hearing loss(SSNHL) with rheumatoid arthritis(RA), and evaluate the effect of the course of RA on the hearing recovery. We collected the clinical data of 43 SSNHL patients(46 ears) with RA(RA group) who were hospitalized in our hospital, and compared their clinical characteristics and prognosis with 386 SSNHL patients(400 ears) without RA(non-RA group). 43 SSNHL patients with RA were further grouped into <5 years group, 5-10 years group and >10 years group, and the hearing recovery was compared among three groups. In the RA group, the initial pure tone average(PTA) of SSNHL and non-SSNHL ears were (64.53±12.77) dB HL and (31.28±8.53) dB HL, which were higher than those in the non-RA group(54.31±13.45) dB HL and(24.83±6.06) dB HL(<0.05). After treatment, in the RA group, posttreatment PTA of SSNHL and non-SSNHL ears were (48.26±13.49) dB HL and (27.93±10.22) dB HL, which were higher than those in the non-RA group (33.65±9.22) dB HL and (21.86±6.88) dB HL(<0.05), and the hearing gains of SSNHL ear and the rate of overall recovery were (16.27±6.01) dB HL and 52.17%, which were lower than those in the non-RA group (20.66±6.21) dB HL and 75.00%. No statistic difference was observed in the hearing gains of non-SSNHL ear between the two groups(>0.05). The hearing gains in the <5 years group, 5-10 years group and >10 years group were (20.77±8.63) dB HL, (17.00±6.81) dB HL and (11.94±5.73) dB HL, statistic differences were observed among the three groups(=0.010), but no statistic difference was observed in the rate of complete recovery, marked recovery, recovery and no recovery(>0.05). SSNHL patients with RA often suffers a severe hearing loss, and the hearing recovery is poor. The longer the course of RA, the worse the prognosis.

摘要

分析类风湿关节炎(RA)伴发突发性感音神经性听力损失(SSNHL)的临床特征及预后,并评估RA病程对听力恢复的影响。我们收集了我院收治的43例RA伴发SSNHL患者(46耳)(RA组)的临床资料,并将其临床特征及预后与386例无RA的SSNHL患者(400耳)(非RA组)进行比较。43例RA伴发SSNHL患者进一步分为病程<5年组、5 - 10年组和>10年组,比较三组的听力恢复情况。RA组中,SSNHL耳及非SSNHL耳的初始纯音平均听阈(PTA)分别为(64.53±12.77)dB HL和(31.28±8.53)dB HL,高于非RA组的(54.31±13.45)dB HL和(24.83±6.06)dB HL(P<0.05)。治疗后,RA组中SSNHL耳及非SSNHL耳的治疗后PTA分别为(48.26±13.49)dB HL和(27.93±10.22)dB HL,高于非RA组的(33.65±9.22)dB HL和(21.86±6.88)dB HL(P<0.05),且SSNHL耳的听力改善值及总体恢复率分别为(16.27±6.01)dB HL和52.17%,低于非RA组的(20.66±6.21)dB HL和75.00%。两组非SSNHL耳的听力改善值差异无统计学意义(P>0.05)。<5年组、5 - 10年组和>10年组的听力改善值分别为(20.77±8.63)dB HL、(17.00±6.81)dB HL和(11.94±5.73)dB HL,三组间差异有统计学意义(P = 0.010),但在完全恢复、显著恢复、恢复及未恢复率方面差异无统计学意义(P>0.05)。RA伴发SSNHL患者常伴有严重听力损失,且听力恢复较差。RA病程越长,预后越差。

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本文引用的文献

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Demystifying autoimmune inner ear disease.揭开自身免疫性内耳疾病的神秘面纱。
Eur Arch Otorhinolaryngol. 2019 Dec;276(12):3267-3274. doi: 10.1007/s00405-019-05681-5. Epub 2019 Oct 11.
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[Correlation study of peripheral blood inflammatory factors in patients with sudden deafness].[突发性聋患者外周血炎症因子的相关性研究]
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Aug;33(8):688-691. doi: 10.13201/j.issn.1001-1781.2019.08.002.
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Hearing status in patients with rheumatoid arthritis.类风湿关节炎患者的听力状况
J Laryngol Otol. 2017 Oct;131(10):895-899. doi: 10.1017/S0022215117001670. Epub 2017 Aug 15.

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