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摘要: 高脂血症是指血脂水平过高，临床表现主要是脂质在血管内皮沉积所引起的动脉硬化。脂代谢异常与突发性聋之间的关系尚不明确。本文报道的1例突发性聋合并家族性高胆固醇血症患者。纯音测听提示单耳中频感音性听力损失，实验室检查提示脂代谢异常，基因检测提示 APOA5 基因杂合突变。诊断为突发性聋；高脂血症，药物治疗效果良好。本文旨在分析总结脂代谢异常与突发性聋可能存在的联系。Abstract: Hyperlipidemia is characterized by elevated levels of blood lipids. The clinical manifestations are mainly atherosclerosis caused by the deposition of lipids in the vascular endothelium. The link between abnormal lipid metabolism and sudden hearing loss remains unclear. This article presents a case study of sudden hearing loss accompanied by familial hyperlipidemia. Pure tone audiometry indicated intermediate frequency hearing loss in one ear. Laboratory tests showed abnormal lipid metabolism, and genetic examination identified a heterozygous mutation in the APOA5 gene. Diagnosis: Sudden hearing loss; hypercholesterolemia. The patient responded well to pharmacological treatment. This paper aims to analyze and discuss thepotential connection between abnormal lipid metabolism and sudden hearing loss.
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Key words:
- sudden hearing loss /
- lipid metabolism /
- hyperlipemia
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表 1 患者实验室及基因检测
实验室检查 指标名称 检测值 正常值范围 总胆固醇/mmol/L 6.14 3.1~5.7 甘油三酯/mmol/L 2.74 0.4~1.7 低密度脂蛋白/mmol/L 4.27 0~3.4 脂代谢异常基因检测 异常基因 基因变异 合子状态 变异分类 APOA5 c.551C>G 杂合 VUS 他汀类药物代谢基因检测 多态性基因 基因变异 合子状态 基因型 SLCO1B1 388A>G 纯合 *1b/*1b APOE 388T>C 杂合 E3/E4 
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表 2 患者入院期间治疗情况
药物名称 剂量 途径 频次 时长 银杏叶提取物注射液 87.5 mg 静滴 1/d 7 d 注射用七叶皂苷钠 10.0 mg 静滴 1/d 7 d 地塞米松磷酸钠注射液 10.0 mg 莫非氏管入 1/d 前3 d 地塞米松磷酸钠注射液 5.0 mg 莫非氏管入 1/d 后3 d 前列地尔注射液 10.0 μg 莫非氏管入 1/d 7 d 甲钴胺注射液 500.0 μg 莫非氏管入 1/d 7 d
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[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 突发性聋诊断和治疗指南(2015)[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(6): 443-447. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEB200608004.htm
[2] Chandrasekhar SS, Tsai Do BS, Schwartz SR, et al. Clinical Practice Guideline: Sudden Hearing Loss(Update)[J]. Otolaryngol Head Neck Surg, 2019, 161(1_suppl): S1-S45.
[3] Schreiber BE, Agrup C, Haskard DO, et al. Sudden sensorineural hearing loss[J]. Lancet, 2010, 375(9721): 1203-1211. doi: 10.1016/S0140-6736(09)62071-7
[4] Rauch SD. Clinical practice. Idiopathic sudden sensorineural hearing loss[J]. N Engl J Med, 2008, 359(8): 833-840. doi: 10.1056/NEJMcp0802129
[5] 王秋菊, 冰丹. 突发性聋的分型诊治与临床研究新进展[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(14): 1095-1099. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.1001-1781.2016.14.001
[6] 张玉娟, 魏迎春, 肖树文, 等. 爆震性聋预防及治疗研究进展[J]. 人民军医, 2021, 64(9): 907-910. https://www.cnki.com.cn/Article/CJFDTOTAL-RMJZ202109029.htm
[7] 石磊, 朱玉华, 于宁, 等. 噪声性聋发生机制及药物防治研究进展[J]. 中国听力语言康复科学杂志, 2020, 18(5): 358-362. https://www.cnki.com.cn/Article/CJFDTOTAL-TLKF202005015.htm
[8] Guardiola M, Ribalta J. Update on APOA5 Genetics: Toward a Better Understanding of Its Physiological Impact[J]. Curr Atheroscler Rep, 2017, 19(7): 30. doi: 10.1007/s11883-017-0665-y
[9] 刘合焜, 王春婷, 张思仲, 等. APOA5基因单核苷酸多态性与冠心病相关性研究[J]. 中华医学遗传学杂志, 2004, 7(4): 335-338. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHYC200404009.htm
[10] 中国中西医结合学会检验医学专业委员会, 浙江省免疫学会临床免疫诊断专业委员会, 浙江省药理学会治疗药物监测研究专业委员会. SLCO1B1和ApoE基因多态性检测与他汀类药物临床应用专家共识[J]. 中华检验医学杂志, 2023, 46(7): 672-680.
[11] 段钰瑾, 李大红, 钟文伟, 等. 代谢综合征对突发性聋患者听力预后的影响[J]. 听力学及言语疾病杂志, 2020, 28(1): 46-49. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ202001013.htm
[12] Oron Y, Elgart K, Marom T, et al. Cardiovascular risk factors as causes for hearing impairment[J]. Audiol Neurootol, 2014, 19(4): 256-260. doi: 10.1159/000363215
[13] 王卫国, 许荣, 陆荣忠. 突发性聋伴高脂血症患者降脂干预的临床研究[J]. 中华耳鼻咽喉科杂志, 2003, 16(5): 336-339. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEB200305006.htm
[14] 柴先奇, 黄若葵, 丁明虹, 等. 高脂血症对突发性聋患者椎基底动脉血流动力学影响[J]. 中国医药科学, 2018, 8(20): 235-237. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX201820072.htm
[15] Marcucci R, Alessandrello Liotta A, Cellai A P, et al. Cardiovascular and thrombophilic risk factors for idiopathic sudden sensorineural hearing loss[J]. J Thromb Haemost, 2005, 3(5): 929-934. doi: 10.1111/j.1538-7836.2005.01310.x
[16] Chang SL, Hsieh CC, Tseng KS, et al. Hypercholesterolemia is correlated with an increased risk of idiopathic sudden sensorineural hearing loss: a historical prospective cohort study[J]. Ear Hear, 2014, 35(2): 256-261. doi: 10.1097/AUD.0b013e3182a76637
[17] Jalali MM, Nasimidoust Azgomi M. Metabolic syndrome components and sudden sensorineural hearing loss: a case-control study[J]. Eur Arch Otorhinolaryngol, 2020, 277(4): 1023-1029. doi: 10.1007/s00405-020-05808-z
[18] Orita S, Fukushima K, Orita Y, et al. Sudden hearing impairment combined with diabetes mellitus or hyperlipidemia[J]. Eur Arch Otorhinolaryngol, 2007, 264(4): 359-362. doi: 10.1007/s00405-006-0196-6
[19] 陆翼年, 雍军, 夏寅, 等. 突发性聋听力损失程度及疗效的多因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(11): 827-834. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2022.11.004
[20] Kojima Y, Ito S, Furuya N. Hearing improvement after therapy for hyperlipidemia in patients with chronic-phase sudden deafness[J]. Ann Otol Rhinol Laryngol, 2001, 110(2): 105-108. doi: 10.1177/000348940111000202
[21] Chen C, Wang M, Wang H, et al. Impact of hyperlipidemia as a coexisting factor on the prognosis of idiopathic sudden sensorineural hearing loss: A propensity score matching analysis[J]. Clin Otolaryngol, 2020, 45(1): 2-11. doi: 10.1111/coa.13421
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