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系统性硬化症患者的听觉-前庭受累。

Audiovestibular Involvement in Patients With Systemic Sclerosis.

机构信息

Otolaryngology Department, Centro Hospitalar do Baixo Vouga, Aveiro.

出版信息

J Clin Rheumatol. 2024 Oct 1;30(7):276-282. doi: 10.1097/RHU.0000000000002131. Epub 2024 Aug 28.

Abstract

INTRODUCTION

Audiovestibular dysfunction has been reported in many autoimmune connective tissue diseases, including systemic sclerosis (SSc).

OBJECTIVE

To assess the prevalence and features of audiological and vestibular disturbances in SSc patients and evaluate their relationship with disease duration, clinical features, nailfold videocapillaroscopy pattern, and immunologic profiles.

METHOD

A matched case-control study was conducted in a rheumatology clinic of a second-level hospital over 24 months. All patients underwent a detailed ear, nose, and throat examination, as well as audiometric and vestibular assessments, including pure tone audiometry, speech audiometry, immittance tests, and the Video Head Impulse Test.

RESULTS

Thirty-five SSc patients and 24 healthy controls were included in the study. In the SSc group, subjective hearing loss was reported by 17.1% of patients, vertigo by 14.3%, tinnitus by 11.4%, and dizziness by 5.7%. Sensorineural hearing loss was identified in 42.9% of SSc patients, significantly higher than in the control group ( p = 0.013). There was no correlation between audiological manifestations and clinical symptoms, organ involvement, immunologic characteristics, and treatment. Vestibular dysfunction was detected in 60% of SSc patients, significantly higher than the control group ( p = 0.05). A significant correlation was found between abnormal Video Head Impulse Test and the presence of anti-RNA polymerase III and anti-Th/To antibodies ( p = 0.05 and p = 0.034, respectively).

CONCLUSION

Our study revealed an increased prevalence of sensorineural hearing loss and vestibulopathy in SSc patients.

摘要

简介

许多自身免疫性结缔组织疾病,包括系统性硬化症(SSc),都有报道称存在听觉-前庭功能障碍。

目的

评估 SSc 患者听力和前庭功能障碍的发生率和特征,并评估其与疾病持续时间、临床特征、甲襞微血管检查模式和免疫特征的关系。

方法

在一家二级医院的风湿病诊所进行了一项为期 24 个月的匹配病例对照研究。所有患者均接受了详细的耳鼻喉检查以及听力和前庭评估,包括纯音听力测试、言语听力测试、声导抗测试和视频头脉冲测试。

结果

研究共纳入 35 例 SSc 患者和 24 例健康对照者。在 SSc 组中,17.1%的患者报告有主观听力损失,14.3%的患者有眩晕,11.4%的患者有耳鸣,5.7%的患者有头晕。SSc 患者中 42.9%存在感音神经性听力损失,明显高于对照组(p=0.013)。听力表现与临床症状、器官受累、免疫特征和治疗均无相关性。SSc 患者中 60%存在前庭功能障碍,明显高于对照组(p=0.05)。异常的视频头脉冲测试与抗 RNA 聚合酶 III 和抗 Th/To 抗体的存在呈显著相关(p=0.05 和 p=0.034)。

结论

我们的研究表明 SSc 患者存在较高的感音神经性听力损失和前庭功能障碍发生率。

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