Sensorineural Hearing Loss and Brain Stem Auditory Evoked Potential Changes During Interferon Therapy: A Prospective Study in Nine Patients

幹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

楊瑞能(Jui-Neng Yang) ； 楊賢馨(Sien-Sing Yang) ； 吳啓華(ChI-Hwa Wu) ； 楊玉繡(Yu-Hsiu Yang) ； 洪朝明(Chao-Ming Hung) ； 陳定信(Ding-Shinn Chen)

《中華民國消化系醫學雜誌》 15卷4期 (1998/12) Pp. 240-245

https://doi.org/10.6557/GJTb.199812_15(4).0003

摘要

我們前瞻性研究12名接受幹擾素治療之慢性B及C型肝炎患者，藉以了解幹擾素治療對聽覺的影響。幹擾素治療每次使用300萬或500萬單位，第一周每天一次皮下注射連續5日，第二至二十四周每周三次皮下注射。所有患者第一周均未使用退燒藥物。所有患者亦未使用影響聽力之藥物如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。檢查於幹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8Hz,55dB於8Hz,55dB於4及8Hz）。治療滿三個月時有二例患者聽力喪失增加15dB（由10dB至25dB於8Hz及由20dB至35dB於4Hz)，二例治療劑量皆使用300萬單位，二例均於婷藥後恢復至治療前聽力（由25dB至10dB及由35dB至30dB)。腦幹聽覺誘發電位於檢查前I-VIPL之平均值為4.27±0.15ms，治療中並未延長4.12±0.14ms ，治療後為4.20±0.14ms(P=0.58)。二例部份聽力喪失患者中兩例有I-VIPL延長現象（由4.27ms至4.36ms and由4.17ms至4.56ms)，但此延長於正常2.5標凖差之內。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％幹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。

關鍵字

聽力喪失 ； 腦幹誘發電位 ； 幹擾素

並列摘要

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 (BAEF) 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 BAEF 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-VIPL. The change of I-VIPLs (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.

並列關鍵字

hearing threshold ； auditory evoked potential ； interferon