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目的分析尿毒症患者维持性血液透析治疗对其听功能的影响。方法选取于2010—2013年在北京大学航天中心医院就诊并行血液透析治疗的尿毒症患者共51例(102耳)作为观察对象,按照透析时间长短分为B组(透析时间<1年,13例)、C组(透析时间1~2年,12例)、D组(透析时间2~3年,11例)和E组(透析时间年>5年,15例)。另外选取年龄、性别情况大体相当的正常人20名(40耳)作为对照组。观察组患者的听觉功能采用听觉脑干反应(ABR)检测。结果对照组、B、C、D、E组ABR检测数值分别为(18.0±2.7)dB nHL、(20.0±3.1)dB nHL、(22.0±3.3)dB nHL、(24.0±3.9)dB nHL和(28.0±4.3)dB nHL。与对照组相比,透析各组的ABR阈值均有显著升高(P<0.05),而且进行透析治疗的各组中,随着维持性血液透析时间的延长,听力受损的情况更加显著(P<0.05)。结论尿毒症患者行血液透析治疗可能对听功能造成损害,随着持续透析时间的延长,听功能损害的程度变得更加明显。
Objective To analyze the effect of maintenance hemodialysis on hearing function in uremic patients. Methods Totally 51 patients (102 ears) with uremia treated by hemodialysis at Peking University Space Center Hospital from 2010 to 2013 were selected as the observation subjects. Patients were divided into group B (dialysis time <1 year, 13 cases ), Group C (dialysis time 1-2 years, 12 cases), group D (dialysis time 2-3 years, 11 cases) and group E (dialysis time> 5 years, 15 cases). In addition, 20 normal subjects (40 ears) with similar age and gender were selected as the control group. The auditory function in the observation group was detected by auditory brainstem response (ABR). Results The values of ABR in the control group were (18.0 ± 2.7) dB nHL, (20.0 ± 3.1) dB nHL, (22.0 ± 3.3) dB nHL, (24.0 ± 3.9) dB nHL and 28.0 ± 4.3) dB nHL. Compared with the control group, ABR thresholds in dialysis groups were significantly increased (P <0.05), and hearing loss was more pronounced with the duration of maintenance hemodialysis in all groups undergoing dialysis P <0.05). Conclusions Hemodialysis may lead to impairment of hearing function in patients with uremia. As the duration of dialysis prolongs, the degree of hearing impairment becomes more obvious.