论文部分内容阅读
目的 :探讨内耳自身免疫性病理因素在迟发性膜迷路积水 (DEH)发病中的作用。方法 :对 2 6例 (同侧性 1 9例 ,对侧性 7例 )DEH患者行临床观察、听觉功能测试、免疫学试验 ;并施以药物治疗、免疫抑制剂治疗、经迷路 耳蜗神经切断术及迷路后前庭神经切断术治疗 ,再进行疗效分析。结果 :特异性抗体阳性 :同侧性 4例 ,对侧性 1例 ;对侧性 1例特异性细胞免疫反应阳性 ;同侧性 1例循环免疫复合物阳性。 1 1例药物治疗可控制眩晕发作 ,8例经行前庭神经切断术后眩晕消失 ,1例行对侧原发性聋耳鼓室成形术后眩晕消失 ,4例免疫抑制剂治疗有效 ,1例自然缓解 ,1例经药物、免疫治疗及内淋巴囊引流术后无效。结论 :导致先期耳聋的常见病因有突发性聋、脑膜炎、麻疹、乳突手术等 ;DEH与原发性聋的间隔期为 1～ 34年。DEH症状较典型梅尼埃病更难控制。内耳自身免疫性病理因素在本病发病中可能起着重要作用。
Objective: To investigate the role of intrinsic autoimmune pathological factors in the pathogenesis of delayed hydatidiform effusion (DEH). Methods: Clinical observation, auditory function test and immunological test were performed in 26 patients (18 with ipsilaterality and 7 with contralateral). The patients were treated with drugs and immunosuppressive agents, Surgery and lost vestibular nerve resection treatment, and then the efficacy analysis. Results: The specific antibody positive: ipsilateral in 4 cases, contralateral in 1 case; contralateral 1 case of specific cellular immune response was positive; ipsilateral 1 case of circulating immune complex positive. 1 case of drug treatment can control the onset of vertigo, 8 cases of vertigo disappeared after vestibular metacarotomy, 1 case of contralateral primary deaf ear dizziness disappeared after tympanoplasty, 4 cases of immunosuppressive agents, 1 case of natural Alleviation, 1 case of drug, immunotherapy and endolymphatic drainage ineffective. Conclusion: The common causes of early deafness are sudden deafness, meningitis, measles and mastoid surgery. The interval between DEH and primary deafness is 1 to 34 years. DEH symptoms are more difficult to control than typical Meniere’s disease. Inner ear autoimmune pathological factors may play an important role in the pathogenesis of this disease.