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目的 观察自身免疫病患者的听力状况。方法 对 2 9例自身免疫病患者询问了病史 ,进行耳镜检查、纯音测听和声导抗测试 ,对其中 12例患者进行了听性脑干反应 (ABR)测试 ,对结果进行了分析。结果 主诉听力下降 2例 4耳 ,耳鸣 4例 6耳 ,耳痛 1耳 ,无眩晕主诉。纯音测听听力正常 2 5耳 ,有传导性听力损失的 8例 14耳 ,其中 10耳为类风湿性关节炎患者 ,强直性脊柱炎和系统性红斑狼疮各 2耳 ;感音神经性听力损失的 11例 19耳。声导抗测试A型鼓室导抗图 44耳 ,B型 4耳 (类风湿性关节炎 3耳 ,系统性红斑狼疮 1耳 ) ,C型 3耳 (类风湿性关节炎 1耳 ,系统性红斑狼疮 2耳 ) ,M型 7耳 ,均为类风湿性关节炎患者。 5 0次 /秒短声 9例 18耳中ABR反应阈轻度升高 (30dBnHL) 3耳 ,各波伏期和波间期正常 2 3耳 ,Ⅰ～Ⅴ波间期异常 1耳 ,为系统性红斑狼疮患者。潜伏期和波间期中有 1项异常的 2人 2耳 ,均为类风湿性关节炎患者。结论 自身免疫病患者有听力损失 ,但多表现为传音系统的损害 ,感音神经性听力损失远较文献报告为低。原因有待继续研究
Objective To observe the hearing status of patients with autoimmune diseases. Methods Twenty-nine patients with autoimmune diseases were asked about their medical history, otoscope examination, pure tone audiometry and acoustic impedance test. Among them, 12 patients were subjected to auditory brainstem response (ABR) test and the results were analyzed. Results The main complaint hearing loss in 2 cases 4 ears, 4 cases of tinnitus 6 ears, ear pain 1 ear, no vertigo complaints. Pure tone audiometry normal hearing 25 ears, 8 cases of conductive hearing loss in 14 ears, of which 10 ears of patients with rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus each 2 ears; sensorineural hearing loss 11 cases of 19 ears. Acoustic conductivity test Type A tympanogram Figure 44 ears, B type 4 ears (rheumatoid arthritis 3 ears, systemic lupus erythematosus 1 ear), C type 3 ears (rheumatoid arthritis 1 ear, systemic erythema Lupus 2 ears), M type 7 ears, are patients with rheumatoid arthritis. 5 0 beats per second Short beeps ABR response thresholds were slightly elevated (30 dBnHL) in 9 ears (18 ears), 3 ears were normal in each wave period and wave interval, and 1 ear was in the interval between Ⅰ and Ⅴ waves. Lupus erythematosus patients. Latent and wave interval in an abnormal 2 2 ears, are patients with rheumatoid arthritis. Conclusion There are hearing loss in patients with autoimmune diseases, but the performance of the acoustic system damage, sensorineural hearing loss is far lower than reported in the literature. The reason to be continued research