摘要
目的 :研究某些感音神经性聋患者血清中是否存在抗内耳血管抗体。方法 :通过临床详细询问病史、纯音测听、声导抗测试及耳声发射筛查 ,选择耳蜗性聋患者 4 0 7例为研究对象 ,其中突发性耳聋 35例 ,Ménière′s病 4 1例 ,不明原因耳蜗性耳聋 331例。以豚鼠内耳石蜡切片作为抗原 ,用间接免疫荧光法检测患者血清中的抗内耳血管抗体。结果 :4 0 7例患者中有 6 9例血清中抗内耳血管抗体阳性 ,阳性率为 16 .95 %。其抗体类型有抗毛细血管内皮抗体 ,抗血管壁弹力纤维抗体 ,抗血管壁内膜和外膜抗体等。 6 9例患者中 ,单纯抗血管壁抗体阳性者 31例 ,占 4 4 .93% ,其余 38例患者还同时存在其它抗内耳抗体。在 6 9例患者中临床诊断突发聋者 12例 ,Ménière′s病者 13例 ,不明原因耳蜗性聋者 4 4例 ,占6 3.77%。 6 9例患者纯音测听结果显示低频听力下降者 4 2例 ,平坦型听力下降者 2 4例 ,高频听力下降者 3例。结论 :某些感音神经性聋患者血清中存在各种类型的抗内耳血管抗体。
Objective:To study whether there are autoantibodies to blood vessel in inner ear of patients with unknown cause of sensorineural deafness.Methods:The serum autoantibodies were examined by the method of indirect immunofluorescence in 407 patients with cochlear deafness.There were 203 males and 204 females,ranging in age from 7 to 70 years old.Among 407 patients,sudden deafness was 35 ,Ménière′s disease 41 and unknown cause 331.The diagnosis of sensorineural deafness was determined by using history,pure tone audiometry and distortion product otoacoustic emission (DPOAE).The paraffin sections of guinea pig temporal bones were incubated with above patients and control group (63 healthy persons)serum and then examined by method of the indirect immunofluorescence.Result:The positive rate of autoantibodies to blood vessel in inner ear was 16 95%(69/407) in which 16 patients are accompanied by dizziness.The types of autoantibodies were to capillary epithelia,elastic fiber in blood vessels,inner wall and outer wall of blood vessel.Among 69 patients,12 were sudden deafness,13 Ménière′s disease ,44 unknown cause of cochlear deafness(63 77%).The shape of the pure tone hearing loss was predominantly low frequency in 42(60 87%),flat across all frequencies in 24(34 78%),predominantly high frequency in 3 only (4 35%).The analysis of kinds of autoantibodies showed that the anti blood vessel was alone in 31 cases,anti inner ear tissue+blood vessel in 38 cases.Conclusion:There were various types of autoantibodies to blood vessel in inner ear on unknown cause of sensorineural deafness,these autoantibodies should be a cause of sensorineural deafness.
出处
《耳鼻咽喉（头颈外科）》
2002年第4期200-202,W001,共4页
Chinese Arch Otolaryngology-Head Neck Surg
