Graves病患者的听力损失与发病机制探讨  

Hearing loss and pathogenesis in Graves’disease

作　　者：胡晓霞[1] 王海东[2] 李洁[1] 刘霞[1] 党静[1] 竺晶 段磊[3] 何继瑞[1] 刘晓雯[3] HU Xiaoxia;WANG Haidong;LI Jie;LIU Xia;DANG Jing;ZHU Jing;DUAN Lei;HE Jirui;LIU Xiaowen(Department of Geriatrics,Second Hospital of Lanzhou University,Lanzhou,Gansu Province,730030;Department of Anesthesiology,Gansu Tumor Hospital,Lanzhou,Gansu Province,730050,China;Department of Otolaryngology,Second Hospital of Lanzhou University,Lanzhou,Gansu Province,730030)

机构地区：[1]兰州大学第二医院老年病科,兰州730030 [2]甘肃省肿瘤医院麻醉科,兰州730050 [3]兰州大学第二医院耳鼻喉科,兰州730030

出　　处：《陆军军医大学学报》2022年第5期489-494,共6页Journal of Army Medical University

基　　金：甘肃省自然科学基金(20JR10RA750)。

摘　　要：目的研究Graves病患者的听力损失情况,探索可能的发病机制。方法纳入2019年9月至2021年3月在兰州大学第二医院门诊和住院部初诊的39例Graves病患者和22名健康对照受试者。HHIE-S量表初步评估受试者有无自觉听力损失,同时进行甲状腺激素和TRAB水平检测、纯音测听和声导抗检查,判断听力损失和激素水平及TRAB的相关性。结果HHIE-S量表显示39例Graves病患者自觉听力损失17例(43.6%),纯音听阈阈值升高23例(59.0%);所有受试者左右耳平均听阈无统计学差异;比较Graves病组和对照组在不同频率的阈值,除1000 Hz外的其他频率Graves病组听阈显著高于健康对照组,差异有统计学意义(P<0.05);在4000和8000 Hz频率时Graves眼病组阈值明显高于Graves非眼病组(P<0.01);Graves病患者纯音听阈与甲状腺激素和TRAB无明显相关性。结论Graves病患者除1000 Hz频率外,其余各检测频率均存在阈值升高而无明显自觉听力损失,合并Graves眼病时4000和8000 Hz高频听力损失更明显。Objective To investigate the hearing loss of Graves patients and explore the possible pathogenesis.Methods A total of 39 Graves patients and 22 healthy control subjects who were initially admitted to the outpatient and inpatient departments of our hospital from September 2019 to March 2021 were enrolled in this study.Hearing Handicap Inventory Screening Version(HHIE-S)was used to assess whether the subjects had conscious hearing loss.Meanwhile,thyroid hormone and thyrotropin receptor antibody(TRAb)levels were detected,and pure tone audiometry and acoustic conductance were performed to judge the correlations of hearing loss with the hormone and TRAb levels.Results HHIE-S scale showed that 17 cases(43.6%)of 39 Graves patients had hearing loss,and 23 cases(59.0%)had increased pure tone threshold.There was no statistical difference in the average auditory threshold of all subjects.The hearing threshold was significantly higher in the Graves group than the healthy control group at frequencies other than 1000 Hz(P<0.05).At 4000 Hz and 8000 Hz,the thresholds of Graves eye disease group was significantly higher than that of Graves non-eye disease group(P<0.01).No significant correlation was found of pure tone threshold with thyroid and TRAb levels in Graves patients.Conclusion Graves patients have no obvious conscious hearing loss at all detection frequencies except 1000 Hz,and the high-frequency hearing loss at 4000 Hz and 8000 Hz is more obvious in those with Graves eye disease.

关 键 词：GRAVES病 听力损失 纯音测听 GRAVES眼病 

分 类 号：R581.1[医药卫生—内分泌] R764.04[医药卫生—内科学]