梅毒阳性突发性耳聋患者的临床特征

Clinical characteristics of syphilis positive patients with sudden hearing loss

目的分析梅毒血清学检验阳性突发性耳聋(简称突聋)患者的临床表现及治疗效果。方法回顾分析8例梅毒血清学检验阳性突聋患者的临床特征、治疗前后听力及伴随症状的改善情况。结果 8例患者中,单耳听力下降4例、双耳听力下降4例;均伴持续性耳鸣,7例伴眩晕,7例伴耳闷。治疗后患者眩晕症状均消失,4例患者耳闷改善,3例患者耳鸣改善。7例患者予突聋常规治疗,3例有效、4例无效;1例患者协同驱除梅毒(简称驱梅)治疗,纯音听阈仅改善5 dB。8例患者中,2例在治疗后达到实用听力(<45 dB)。结论梅毒血清学检验阳性的突聋患者双耳听力下降的可能性大,但损害程度不对称,合并耳鸣、耳闷、眩晕比例较高。常规突聋治疗方案对眩晕的控制效果好,但对听力的改善效果欠佳。联合驱梅治疗可能有助于改善听力。

Objective To analyze the clinical manifestations and therapeutic effect of sudden deafness with positive syphilis serological test. Methods The clinical features,hearing levels before and after treatment and the improvement of accompanying symptoms in 8 patients with Syphilis Serological positive sudden deafness were analyzed retrospectively. Results Among the 8 patients with syphilis positive sudden deafness, there were 4 cases with unilateral hearing loss and 4 cases with bilateral hearing loss. All patients were accompanied with persistent tinnitus, 7 cases with vertigo and 7 cases with ear tightness. After treatment, dizziness all disappeared, ear tightness improved in 4 cases(57%), tinnitus improved in 3 cases(37.5%). In the 7 cases after routine treatment, 3 cases were effective, 4 cases were ineffective;1 case was treated with anti syphilis therapy and improved by 5 dB in hearing, and the curative effect was evaluated as invalid. Only 2 cases achieved practical hearing( <45 dB) after treatment, and there were no cured and markedly effective patients. Conclusions with Sudden deafness in Syphilis Serological test positive patient more likely occur bilaterally at the same time, but the degree of damage is not symmetrical, and the proportions of tinnitus, ear tightness and vertigo are high. For routine treatment,the control of vertigo is good, but the effect of hearing improvement is not good. At the same time, anti-syphilis treatment may help to improve hearing.