2型糖尿病患者肾脏病变与听力损失的相关性

doi:10.3969/j.issn.1006-7795.2019.01.006

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (1): 27-34.doi: 10.3969/j.issn.1006-7795.2019.01.006

• 糖尿病慢性合并症-听力损失与平衡障碍研究 • 上一篇下一篇

2型糖尿病患者肾脏病变与听力损失的相关性

赵明月¹, 刘博², 王鹏³, 杨毅⁴

1. 北京航天总医院干部医疗科, 北京 100076;
2. 首都医科大学附属北京同仁医院, 耳鼻喉头颈外科北京市耳鼻咽喉科研究所, 北京 100730;
3. 首都医科大学附属复兴医院综合科, 北京 100038;
4. 首都医科大学附属北京同仁医院内分泌科, 北京 100730

收稿日期:2018-12-06 出版日期:2019-01-21 发布日期:2019-01-23
通讯作者: 杨毅 E-mail:yangyi302tr@126.com
基金资助:
首都卫生发展科研专项（首发重点2018-1-1091）。

Relationship between diabetic nephropathy and hearing loss in type 2 diabetes mellitus

Zhao Mingyue¹, Liu Bo², Wang Peng³, Yang Yi⁴

1. Department of Cadre Medical, Beijing Aerospace General Hospital, Beijing 100076, China;
2. Department of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Otorhinolaryngology, Beijing 100730, China;
3. Department of General Medical, Fuxing Hospital, Capital Medical University, Beijing 100038, China;
4. Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Received:2018-12-06 Online:2019-01-21 Published:2019-01-23
Supported by:
This study was supported by Capital Health Research and Development of Special(2018-1-1091).

摘要/Abstract

摘要： 目的通过比较2型糖尿病（type 2 diabetes mellitus，T2DM）患者在不同肾脏病阶段的听力情况，探讨糖尿病（diabetes mellitus，DM）肾病（diabetic nephropathy，DN）与听力损失的相关性。方法根据尿白蛋白排泄率（urinary albumin excretion rate，UAER）选择未合并肾病糖尿病组DM组40例、早期糖尿病肾病组（DNⅢ组）28例、临床期糖尿病肾病组（DNⅣ组）27例，并测定相应的肾小球滤过率及血肌酐浓度。采用对照研究的方法，通过纯音测听、声导抗检测，比较不同受试组听力水平差异。结果 DM组、DNⅢ组、DNⅣ组受试者听力损失检出率分别为60.0%、71.4%、92.6%，且主要表现为高频听力损失，高频听力损失检出率分别为52.5%、67.9%、92.6%，差异有统计学意义（P<0.05）。纯音测听结果显示，随着检测频率的增高，各组受试者的听阈均呈升高趋势；DNⅢ组、DNⅣ组在所有检测频率的听阈均高于DM组（P<0.01），在250、500、1 000、4 000 Hz范围内，各组的听阈DNⅣ组高于DNⅢ组高于DM组（P<0.01）。相关分析显示，高频平均听阈与尿白蛋白排泄率水平呈正相关（r=0.346，P=0.001），与肾小球滤过率水平呈负相关（r=-0.230，P=0.025）。结论 2型糖尿病患者听力损失与肾脏病变存在相关性，随着肾脏病变的加重，听力损失发生的风险增高。发现糖尿病肾病的患者应积极进行听力筛查，以便能早期发现听力问题并给予及时的干预措施。

关键词: 2型糖尿病, 糖尿病肾病, 听力损失

Abstract: Objective To investigate the relationship between diabetic nephropathy (DN) and hearing loss in type 2 diabetes mellitus (T2DM) patients with different stages of renal function by testing the performance on auditory function. Methods According to the urinary albumin excretion rate (UAER), 40 patients with non-diabetic nephropathy (DM group), 28 patients with early diabetic nephropathy (DN Ⅲ group), and 27 patients with clinical diabetic nephropathy (DN Ⅳ group) were collected in this study. The glomerular filtration rate (GFR) and creatinine (Cr) were simultaneously tested, and then the auditory function were compared via examination of the pure tone audiometry and a coustic immittance. Results The hearing loss in DM, DN Ⅲ and DN Ⅳ groups mainly occurred at high frequency, with incidence of 60.0%, 71.4% and 92.6%, respectively, The difference is statistically significant. Pure tone audiometry results suggested an increased trend in the hearing threshold with the increase of the frequency of detection.The hearing threshold of DN Ⅲ and DN Ⅳ groups were higher than DM group at all frequencies (P<0.01). The hearing threshold of DN Ⅳ group was higher than that of DN Ⅲ group, and DN Ⅲ group higher than DM group at 250, 500, 1 000, 4 000 Hz (P<0.01). Correlation analysis showed that hearing threshold at high frequency was positively correlated with UAER (r=0.346, P=0.001), but negatively correlated with GFR (r=-0.230,P=0.025). Conclusion Diabetic nephropathy was closely correlated with hearing loss in patients with type 2 diabetes mellitus, the risk of hearing loss increased with an exacerbation of kidney disease. The hearing screening of patients with DN should be performed actively to detect hearing defectiveness and intervene at very early stage.

Key words: type 2 diabetes mellitus, diabetic nephropathy, hearing loss

中图分类号:

R587.1

赵明月, 刘博, 王鹏, 杨毅. 2型糖尿病患者肾脏病变与听力损失的相关性[J]. 首都医科大学学报, 2019, 40(1): 27-34.

Zhao Mingyue, Liu Bo, Wang Peng, Yang Yi. Relationship between diabetic nephropathy and hearing loss in type 2 diabetes mellitus[J]. Journal of Capital Medical University, 2019, 40(1): 27-34.

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2型糖尿病患者肾脏病变与听力损失的相关性

Relationship between diabetic nephropathy and hearing loss in type 2 diabetes mellitus

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