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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 (hearingloss ,HL)组和听力正常 (hearingnormal,HN)组。 (2 )应用纯音测听法和听性脑干反应(auditorybrainstemresponse ,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 5 7.14 %、17.14 %和 8.5 7%。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 .3 3 % ;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 explore the relationship between sensorineural deafness and islet autoantibodies in patients with autoimmune diabetes. Methods: (1) Sixty-five patients with diabetes were divided into hearing loss (HL) group and hearing normal (HN) group according to whether they had hearing loss or not. (2) Totally 65 diabetic patients were tested with pure tone audiometry and auditory brainstem response (ABR) for audiological analysis. (3) The islet autoantibodies and other related items in the above two groups were detected by ELISA, radioimmunoassay and clinical biochemistry respectively: GADA, ICA, Insulin antibody (IAA), islet B cell function and diabetes-related indicators. Results: The HL group was sensory nerve deafness, accounting for 92.85% of the total. The ABR test showed cochlear deafness. The positive rates of GADA, ICA and IAA were 51.14% and 17.14 respectively % And 8.5 7%. The hearing tests in HN group were basically normal. The positive rates of the three antibodies were only 0,6.67% and 3.33% respectively. Meanwhile, the function of islet B cells and diabetes-related indicators in HL group were worse than those in HN group. Conclusion: The existence of islet autoantibodies in patients with autoimmune diabetes may be one of the indirect causes of hearing impairment. It is not clear whether islet autoantibodies directly damage the hearing aids through antigen-antibody reaction, which remains to be further studied.