感音神经性聋与自身免疫性糖尿病关系临床初探-东南大学学报医学版

感音神经性聋与自身免疫性糖尿病关系临床初探

单位：1.东南大学附属中大医院耳鼻咽喉科,； 2.东南大学附属中大医院内分泌科,

分类号：R764.43+1, R587.1

出版年·卷·期（页码）：2001·20·第一期（39-41）

摘要：

目的：探讨感音神经性聋与自身免疫性糖尿病患者胰岛自身抗体之间的关系。方法：(1)65例糖尿病患者按是否伴听力减退分为听力减退(hearing loss,HL)组和听力正常(hearing normal,HN)组。(2)应用纯音测听法和听性脑干反应(auditory brainstem response,ABR)检测65例糖尿病患者并进行听力学分析。(3)继以酶联免疫法、放射免疫法及临床生化等方法分别测定上述两组患者的胰岛自身抗体及其他相关项目：谷氨酸脱羧酶抗体(GADA )、胰岛细胞抗体(ICA)、胰岛素抗体(IAA)、胰岛B细胞功能及糖尿病相关指标。结果：HL组为感音神经性聋，以高频损害为主，占92.85%，ABR检测提示为耳蜗性聋；胰岛自身抗体GADA、ICA和IAA的阳性率分别为57.14%、17.14%和8.57%。而HN组听力检查基本正常，上述3种抗体的阳性率仅分别为0、6.67%和3.33%；同时HL组胰岛B细胞功能及糖尿病相关指标均较HN组恶化。结论：自身免疫性糖尿病患者胰岛自身抗体的存在可能是间接引起听力损害的原因之一，胰岛自身抗体是否通过抗原抗体反应直接损害听器尚不清楚，有待进一步研究。

Objective To investigate the relationship between the sensorineural hearing loss and autoimmune Diabetes mellitus insulin autoantibodies.Method 1.65 patients were divided into hearing loss(HL) group and hearing normal(HN) group according to whether accompany with hearing loss.2.By means of pure tone audiometry (PTA) and auditory brainstem response (ABR) we analyzed the characteristics of hearing loss in 65 diabetic cases.3.ELISA,radioimmunoassay and clinical biochemistry techniques were used to detect the insulin autoantibodies(GADA,ICA and IAA),islet B cell function and diabe~tic related indices respectively.Result Group HL were sensorineural hearing loss,in which 92.85% were high frequency hearing loss; The positive rates of insulin autoantibodies such as GADA,ICA and IAA were 57.14%,17.14% and 8.57% respectively;The positive rates were 0,6.67% and 3.33% respectively in group HN;meanwhile the islet B cell function and diabetic related indices were worsen in group HL than group HN.Conclusion The existence of islet autoantibodies in auto~immune diabetic patients might be one of the indirectly causes of hearing damage.It is not clear that whether insulin autoantibo~dies directly cause hearing damage by autoimmune reaction.

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