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題名 | Sensorineural Hearing Loss and Brain Stem Auditory Evoked Potential Changes During Interferon Therapy: A Prospective Study in Nine Patients=干擾素治療引起之輕度聽力喪失及腦幹誘發電位變化:九病例前瞻性研究 |
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作 者 | 楊瑞能; 楊賢馨; 吳啟華; 楊玉繡; 洪朝明; 陳定信; | 書刊名 | 中華民國消化系醫學雜誌 |
卷期 | 15:4 1998.12[民87.12] |
頁次 | 頁18-23 |
分類號 | 418.1 |
關鍵詞 | 聽力喪失; 腦幹誘發電位; 干擾素; Hearing threshold; Auditory evoked potential; Interferon; |
語文 | 英文(English) |
中文摘要 | 我們前瞻性研究 12 名接受干擾素治療之慢性 B 及 C 型肝炎忠者,藉以了解干 擾素治療對聽覺的影響。干擾素治療每次使用 300 萬或 500 萬單位,第一週每天一次皮下 注射連續 5 日,第二至二十四週每週三次皮下注射。 所有患者第一週均未使用退燒藥物。 所有患者亦未使用影響聽力藥物如 Aminoglycosides 等。 聽力測驗及腦幹聽覺誘發電位均 於隔音室由對病情不瞭解之專業聽力師檢查。檢查於干擾素開始治療前三天內、治療滿三個 月及治療結束後一個月分別為之。有三名患者因治療開始三個月內中止治療而排除。其餘九 位患者中有三位於治療前有 30dB 以上之聽力喪失( 60 dB 於 4 及 8 Hz, 55 dB 於 8 Hz, 55 dB 於 4 及 8 Hz )。治療滿三個月時有二例患者聽力喪失增加 15 dB (由 10 dB 至 25 dB 於 8 Hz 及由 20 dB 至 35 dB 於 4 Hz ),二例治療劑量皆使用 300 萬單位, 二例均於停藥後恢復至治療前聽力(由 25 dB 至 10 dB 及由 35 dB 至 30 dB )。腦幹聽 覺誘發電位於檢查前Ⅰ - Ⅴ IPL 之平均值為 4.27 ± 0.15 ms,治療中並未延長 4.12 ± 0.14 ms,治療後為 4.20 ± 0.14 ms ( P=0.58 )。二例部份聽力喪失患者中兩例有Ⅰ - Ⅴ IPL 延長現象(由 4.27 ms 至 4.36 ms and 由 4.17 ms 至 4.56 ms ), 但此延長於 正常 2.5 標準差之內。所有患者均否認有自覺性聽覺變化及耳鳴等現象。 本研究顯示 22% 干擾素治療患者可有輕度聽力受損,此變化可於停藥後恢復,腦幹聽覺誘發電位則無有意義 之變化。 |
英文摘要 | We prospectively studied the sensorineural hearing loss in 12 patients who underwent interferon therapy. Interferon alfa was subcutaneously injected at a dose of 3 or 5 million units daily for 5 days in the first week and then thrice weekly until 6 months. None of our patients received analgesics for fever in the first week, and none received any medications affecting hearing ability. The audiometry and brain-stem auditory evoked potentials (BAEP) were assessed prior to, at 3 months of interferon therapy and at one month after the end of therapy. Three patients were excluded for incomplete follow-up. Three of the remaining 9 patients had a hearing threshold > 30 dB (60 dB at 4 and 8 Hz, 55 dB at 8 Hz, and 55 dB at 4 and 8 Hz) prior to the therapy. Two of them experienced with a 15-dB (from 10 dB to 25 dB at 8 Hz and from 20 dB to 35 dB at 4 Hz) increase of hearing threshold at 3 months of therapy. Their hearing threshold improved after the termination of interferon therapy (from 25 dB to 10 dB and from 35 dB to 30 dB). The Ⅰ-Ⅴ interpeak latency (IPL) of BAEP was 4.27±0.15, 4.12±0.14, and 4.20±0.14 ms prior to, at 3 months, and at one month after therapy, respectively. None of the patients had abnormal Ⅰ-Ⅴ IPL. The change of Ⅰ-Ⅴ IPLs (from 4.27 ms to 4.36 ms and from 4.17 ms to 4.56 ms) during interferon therapy was not significant. Our preliminary study showed 22% of patients had mild sensorineural hearing impairment during interferon therapy; this impairment was reversible after the termination of therapy. The brainstem function was preserved during interferon therapy. However, our case number is small, further study with larger case number is necessary. |
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