Ani işitme kayıplı hastalarda immunolojik ve viral faktörlerin etyolojideki önemi
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Tarih
2016
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma ani işitme kaybı etiyolojisinde viral ve immunolojik faktörlerin rolünü araştırmak için yapıldı. Prospektif, plasebo kontrollu bir çalışmadır. Çalışmaya Ocak 2010 ile Kasım 2011 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi KBB polikliniğine ani işitme kaybı şikayeti ile başvuran 40 hasta (32 si erkek 8 i bayan; En büyük yaş 72, en küçük yaş 9 idi ve ortalama yaş 36,4 ) ile sağlıklı 40 kontrol vakası (28 i erkek 12 si bayan, büyük yaş 81, en küçük yaş 6 ve ortalama yaş 36 ) dahil edildi. her iki grubun kan örnekleri birbiri ile karşılaştırıldı. Ani işitme kayıplı (AİK) hastalarda ve kontrol grubunda viral (Hbs Ag, Anti-Hbs, CMV İgM, CMV İgG, Rubella İgM, Rubella İgG, Ebstein-Barr Virüs-İgM, EBV-İgG, Herpes Simplex Virüs 1 İgM, HSV 1 İgG, HSV 2 İgM, HSV 2 İgG, Mumps İgG, Mumps İgM, anti-HİV) ve immünolojik (Antinükleer antikor, Anti ds-DNA, Antikardiolipin İgM, Antikardiolipin İgG, ASO, CRP, RF, İgG, İgM, C3, C4) markerler incelendi. Sonuçlar: Ani işitme kayıplı hastaların 26 sı sağ kulak 14 ü sol kulak etkilenmişti. Her iki grup kendi arasında karşılaştırıldı. Ani işitme kayıplı hastaların işitme kaybı ortalaması 69,82 idi (42db ile 113db arasında). Kesikli değişkenler çarpraz tablolar haline dönüştürülerek Yates düzeltmeli Ki-Kare testi ile analiz edildi. Yapılan istatistiksel analizler sonucunda, viral etkenler gözününe alındığında, her iki grupta da anlamlı bir fark saptanmadı. İmmünolojik markerlerden C4 ortalama değerleri her iki grupta da normal sınırlar içerisinde seyretmesine rağmen; hasta grubunun ortalama değerleri, kontrol grubu ile karşılaştırıldığında daha düşük bulunmuş ve bu fark istatistiksel olarak anlamlı çıkmıştır. Elde edilen bu veriler ve analizler doğrultusunda hasta grubunda düşük C4 değerleri AİK etyopatogenezinde inflamatuar ve immün mekanizmaların rol alabileceğini düşündürmüştür. Bununla beraber ani işitme kayıplı hastalarla sağlıklı bireyler arasında yaptığımız viral ve immunolojik faktörlerin serum değerlerin de önemli bir fark bulunmamıştır. ANAHTAR SÖZCÜKLER: Ani işitme kaybı, sensorinöral işitme kaybı, etyoloji, viral enfeksiyon, immunolojik faktörler
The aim of this study was to investigate the role of viral and immunologic factors in the etiology of idiopathic sudden hearing loss. This study was designed as a prospective placebo controlled study. Forty patients with idiopathic sudden deafness (32 males, 8 females, mean age 36.4 years; range 9 to 72 years) and 40 healthy control subjects (28 males, 12 females; mean age 36 years; range 6 to 81 years) who had been admitted to ENT Department of Dicle University Medical Faculty, between January 2010 and October 2011 were included in the study. In both patient and control group, serum levels of viral (Hbs Ag, Anti-Hbs, CMV-IgM, CMV-IgG, Rubella-IgM, Rubella-İgG, Ebstein-Barr Virüs-İgM, EBV-IgG, Herpes Simplex Virus 1-İgM, HSV-IgG, HSV2-İgM, HSV2-IgG, Mumps-İgG, Mumps İgM,anti-HIV) and immunologic markers (Antinuclear antikor, Anti ds-DNA, Anticardiolipin-İgM, Anticardiolipin-İgG, ASO, CRP, RF, IgG, IgM, C3, C4) were analyzed. Sudden deafness involved the right ear in 26 patients and the left ear in 14 patients. The mean hearing loss was 69.8 dB (range 42 to 113 dB). Cross-tables by converting the discrete variables were analyzed by Yates-corrected with chi-square test. No significant differences were found between the patients and controls regarding the viral factors including hepatitis, human immunodeficiency virus, cytomegalovirus, rubella, mumps, Epstein-Barr virus, and herpes simplex virus. The mean serum levels of immunologic markers including complement 4 (p=0.009) were significantly low in the patient group; however, they all were within the reference ranges. According to the our results, it can be suggested that, lower C4 levels can take a role in the etiopathogenesis of inflammatory and immune mechanisms in the sudden deafness patients. However, there was no significant difference in terms of serum levels of viral and immunological factors between patients with sudden hearing loss and healthy individuals. KEYWORDS: Sudden deafness, Sensorineural hearing loss, Etiology, Viral infection, İmmunologic factors
The aim of this study was to investigate the role of viral and immunologic factors in the etiology of idiopathic sudden hearing loss. This study was designed as a prospective placebo controlled study. Forty patients with idiopathic sudden deafness (32 males, 8 females, mean age 36.4 years; range 9 to 72 years) and 40 healthy control subjects (28 males, 12 females; mean age 36 years; range 6 to 81 years) who had been admitted to ENT Department of Dicle University Medical Faculty, between January 2010 and October 2011 were included in the study. In both patient and control group, serum levels of viral (Hbs Ag, Anti-Hbs, CMV-IgM, CMV-IgG, Rubella-IgM, Rubella-İgG, Ebstein-Barr Virüs-İgM, EBV-IgG, Herpes Simplex Virus 1-İgM, HSV-IgG, HSV2-İgM, HSV2-IgG, Mumps-İgG, Mumps İgM,anti-HIV) and immunologic markers (Antinuclear antikor, Anti ds-DNA, Anticardiolipin-İgM, Anticardiolipin-İgG, ASO, CRP, RF, IgG, IgM, C3, C4) were analyzed. Sudden deafness involved the right ear in 26 patients and the left ear in 14 patients. The mean hearing loss was 69.8 dB (range 42 to 113 dB). Cross-tables by converting the discrete variables were analyzed by Yates-corrected with chi-square test. No significant differences were found between the patients and controls regarding the viral factors including hepatitis, human immunodeficiency virus, cytomegalovirus, rubella, mumps, Epstein-Barr virus, and herpes simplex virus. The mean serum levels of immunologic markers including complement 4 (p=0.009) were significantly low in the patient group; however, they all were within the reference ranges. According to the our results, it can be suggested that, lower C4 levels can take a role in the etiopathogenesis of inflammatory and immune mechanisms in the sudden deafness patients. However, there was no significant difference in terms of serum levels of viral and immunological factors between patients with sudden hearing loss and healthy individuals. KEYWORDS: Sudden deafness, Sensorineural hearing loss, Etiology, Viral infection, İmmunologic factors
Açıklama
Anahtar Kelimeler
Ani işitme kaybı, Sudden deafness, Sensorinöral işitme kaybı, Sensorineural hearing loss, Etyoloji, Etiology, Viral enfeksiyon, Viral infection, İmmunolojik faktörler, Immunologic factors
