强直性脊柱炎患者的听力表现

基础医学与临床 ›› 2021, Vol. 41 ›› Issue (2): 214-218.

强直性脊柱炎患者的听力表现

王轶¹, 苏金梅^2*, 王素菊¹, 栾岚¹, 高志强¹

中国医学科学院北京协和医学院北京协和医院 1.耳鼻喉科; 2.风湿免疫科, 北京 100730

收稿日期:2020-10-12 修回日期:2020-11-24 出版日期:2021-02-05 发布日期:2021-01-19
通讯作者: ^*sujm@pumch.cn

Audiologic profile of patients with ankylosing spondylitis

WANG Yi¹, SU Jin-mei^2*, WANG Su-ju¹, LUAN Lan¹, GAO Zhi-qiang¹

1. Department of Otolaryngology; 2. Department of Rheumatology & Immunology, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China

Received:2020-10-12 Revised:2020-11-24 Online:2021-02-05 Published:2021-01-19
Contact: ^*sujm@pumch.cn

摘要/Abstract

摘要： 目的强直性脊柱炎患者的听力表现鲜有报道,本文参与探讨“强直性脊柱炎是否有传导性聋”存在的争议。方法通过横断面临床研究观察24例强直性脊柱炎患者的纯音测听、鼓室压曲线、畸变产物耳声发射、听性脑干反应,并与25例年龄性别匹配的正常对照进行比较。结果强直性脊柱炎患者听力下降发生率29%,其中感音神经性聋21%,传导性聋8%,明显高于正常对照组(P＜0.05)。鼓室压曲线“As”型明显高于对照组(P＜0.05)。传导性聋可能由听骨链受累引起。感音神经性聋为耳蜗受累,未发现蜗后病变。女性听力下降发生率高。结论强直性脊柱炎患者听力下降发生率较高,听力下降可能是强直性脊柱炎关节外表现之一;强直性脊柱炎存在传导性聋,传导性聋发生率低于感音神经性聋;强直性脊柱炎患者听力下降以耳蜗和听骨链受累为主。

关键词: 强直性脊柱炎, 听力下降, 感音神经性聋, 传导性聋, 关节外表现

Abstract: Objective To describ the audiologic profile of patients with ankylosing spondylitis. Methods This comparative cross-sectional study on the auditory evaluations was carried out with 24 patients and 25 controls including the pure tone audiometry, tympanometry, distortion product otoacoustic emissions (DPOAE) and auditory brainstem response (ABR) to identify the prevalence, type of hearing loss in diagnosed ankylosing spondylitis patients. Results The prevalence of hearing loss in patient group was 29%, sensorineural hearing loss was 21%, and conductive hearing loss was 8%, which were all significantly higher than that of the control group(P＜0.05). Tympanic pressure curve type“As” was significantly higher than that of control group (P＜0.05). The cochlea was mainly involved in sensorineural hearing loss. Hearing loss affected female more often. Conclusions The prevalence of hearing loss is high, especially in female patients. Hearing loss may be an extra-articular feature of ankylosing spondylitis. Conductive hearing loss may be resulted from the arthritis of the ossicular chain.

Key words: ankylosing spondylitis, hearing loss, sensorineural hearing loss, conductive hearing loss, extra-articular manifestations

中图分类号:

R593.23

王轶, 苏金梅, 王素菊, 栾岚, 高志强. 强直性脊柱炎患者的听力表现[J]. 基础医学与临床, 2021, 41(2): 214-218.

WANG Yi, SU Jin-mei, WANG Su-ju, LUAN Lan, GAO Zhi-qiang. Audiologic profile of patients with ankylosing spondylitis[J]. Basic & Clinical Medicine, 2021, 41(2): 214-218.

参考文献

[1] Ajmani S, Keshri A, Srivastava R, et al. Hearing loss in ankylosing spondylitis[J]. Int J Rheum Dis, 2019,22:1202-1208.
[2] Chao WC, Lin CH, Chen YM, et al. Association between tonsillitis and newly diagnosed ankylosing spondylitis: a nationwide, population-based, case-control study[J]. PLoS One, 2019,14:e0220721. doi: 10.1371/journal.pone.0220721.
[3] Kook H, Jin SH, Lee S, et al. Radiographic progression in patients with ankylosing spondylitis according to uveitis based on the observation study of Korean spondyloarthropathy registry[J]. Arch Rheumatol, 2019,35:1-6.
[4] Stolwijk C, van Tubergen A, Castillo-Ortiz JD, et al. Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis [J]. Ann Rheumatic Dis,2015,74:65-73.
[5] van der Horst-Bruinsma IE, Nurmohamed MT. Management and evaluation of extra-articular manifestations in ankylos-ing spondylitis [J]. Ther Adv Musculoskelet Dis,2012,4:413-422.
[6] Yagueshita L, Lucinda LR, Azevedo V, et al. Audiologic profile in patients with ankylosing spondylitis: a control-led study of 30 patients [J]. Ear Nose Throat J,2018,97:18-22.
[7] Amor-Dorado JC, Barreira-Fernandez MP, Vazquez-Rodriguez TR, et al. Audiovestibular manifestations in patients with ankylosing spondylitis [J]. Medicine (Baltimore),2011,90:99-109.
[8] Magaro M,Ceresia G,Frustaci A. Arthritis of the middle ear in ankylosing spondylitis [J]. Ann Rheum Dis,1984,43: 658-659.
[9] De Miguel E, Tomás M, Benito S, et al. Ankylosing spondylitis and middle ear impairment [J]. Ann Rheum Dis,1987,46:174.
[10] Adam M, Erkan AN, Arslan D, et al. High-frequency sensorineural hearing loss in patients with ankylosing spondylitis: Is it an extrarticuler feature of disease[J]. Rheumatol Int, 2008,28:413-417.
[11] Bozan N, Alpayc M, Aslan M, et al. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds[J]. Eur Arch Otorhinolaryngol,2016,273:3663-3672.
[12] Karata? D, Doğan I, Ekinci A, et al. Evaluation of auditory and cochlear functions in ankylosing spondylitis patients according to the site of involvement [J]. Eur Arch Otorhinolaryngol,2017, 274:3875-3881.
[13] Dagli M, Sivas Acar F, Karabulut H, et al. Evaluation of hearing and cochlear function by DPOAE and audiometric tests in patients with ankylosing spondylitis [J]. Rheumatol Int, 2007,27:511-516.
[14] 王戈平,刘玉怀,鲍垂,等. 强直性脊柱炎患者的听力学及抗膜迷路蛋白抗体的检测[J]. 中华耳鼻咽喉科杂志, 2000,35:117-119.