Zanetti D, Franceschini F, Antonelli A R
Otorhinolaryngologic Clinic, University of Brescia, Italy.
Acta Otorhinolaryngol Belg. 1994;48(1):71-9.
The identification of a possible autoimmune etiology for a sensorineural hearing loss (SNHL) is essential for a successful medical treatment. Confirmation of diagnosis in clinically "high-risk" patients is provided by antigen-specific tests, which are not easily obtainable on a routine basis in the otologic clinic; on the other hand the reliability of non-specific-antigen tests is questioned. The outcome of serological tests in a group of patients with possible autoimmune SNHL were compared with those obtained in two control groups, one of normal subjects and one with systemic autoimmune disorders. The test battery included the dosage of circulating aspecific autoantibodies (anti-nuclear, anti-perinuclear factor, anti-mitochondrial, anti-smooth muscle), the total haemolytic activity (CH50), the immunoglobulin fractions and the aspecific inflammation indexes. At the p level of 0.05, none of the findings reached statistical significance, except for low CH50 in 31% of SNHL patients. Complement consumption is an indirect indicator of the presence of immunocomplexes. The serum dosage of the total haemolytic activity is suggested as screening. Investigation to detect circulating immunocomplexes is to be extended to patients with low CH50 levels.
确定感音神经性听力损失（SNHL）可能的自身免疫病因对于成功的医学治疗至关重要。临床上“高风险”患者的诊断通过抗原特异性检测来确认，而这些检测在耳科诊所很难常规获得；另一方面，非特异性抗原检测的可靠性受到质疑。将一组可能患有自身免疫性SNHL患者的血清学检测结果与两个对照组（一组正常受试者和一组患有全身性自身免疫性疾病的患者）的结果进行了比较。检测项目包括循环中特异性自身抗体（抗核抗体、抗核周因子、抗线粒体抗体、抗平滑肌抗体）的定量、总溶血活性（CH50）、免疫球蛋白组分以及非特异性炎症指标。在0.05的P值水平上，除31%的SNHL患者CH50较低外，其他结果均未达到统计学意义。补体消耗是免疫复合物存在的间接指标。建议检测血清总溶血活性作为筛查手段。对于CH50水平较低的患者，应进一步开展检测循环免疫复合物的研究。
