低频感音神经性聋患者的内耳免疫学探讨

<title>ner ear immune alteration in patient with sen-sorineural deafness in low frequency

目的 测定抗内耳自身抗体,以研究低频感音神经性耳聋患者与内耳免疫的相关性。方法 通过临床详细询问病史、纯音测听、声导抗测试及ABR测试,选择低频感音神经性聋患者30例做为研究对象。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抗体。结果 30例患者中有26例血清中抗内耳抗体阳性,阳性率为86.67%,P<0.01有极显著性差异;低频感音神经性聋在青少年组(≤25岁)和女性组呈高发,阳性率均为63.33％(19／30),P<0.05有显著性差异;低频感音神经性聋多为双侧耳聋,少数为单侧耳聋,双侧耳聋阳性率为86.67%(26／30),P<0.01有极显著性差异。结论 自身免疫反应参与了低频感音神经性聋的发病过程;低频感音神经聋与年龄和性别有关;低频感音神经性聋发病多为双侧聋;同时检测患者血清ⅠgM和ⅠgG内耳抗体,可协助诊断。

<abstract>JECTIVE To study the relativity between patients with sensorineural deafness in low frequency and inner ear immune abnormality. METHODS Thirty patients with sensorineural deafness in low frequency were selected from 400 patients with autoimmune disease in iner ear. The sample of the temporal bones embeded with paraffin in guinea pig being used as antigen, their serum autoantibodies were examined by indirect immunofluorescence. RESULTS The positive rate of autoantibodies in inner ear in 30 patients was 86.67 %(26/30), and presented significant differences(P < 0.01)compared with the control group. Low frequency sensorineural deafness more easily happened in juvenile group(≤25 years old) and female group ,the positive rate were 63.33 %(19/30, P< 0.05). Low frequency sensorineural deafness more often presented bilateral deafness and the positive rate was 86.67 %(26 / 30, P< 0.01). CONCLUSION Autoimmu-nity reaction maybe involve in the development of sensorineural deafness in lowfrequency. Sensorineural deafness in low frequency is different in different age and sex change. It more often presents in bilateral deafness .Combined detection of IgM and IgG in inner ear antibody in serum may help to diagnose.