摘要
目的分析以耳部症状为首发症状的韦格纳肉芽肿的临床特点,探讨韦格纳肉芽肿早期诊断及治疗方法。方法回顾性分析3例以耳部症状为首发症状的韦格纳肉芽肿病例,并查阅相关文献3例,分析、总结这些病例的临床表现、诊疗经过、确诊方式、治疗方法及预后结果 6例患者早期均以耳闷、听力下降,耳痛作为首发症状,其中4例患者出现面瘫,早期均误诊为中耳炎而给予药物或手术治疗,确诊可结合临床表现,血清血标志ANCA或c-ANCA,及典型的病理表现,免疫抑制及激素治疗是目前主要治疗方案。结论以耳部症状为首发症状的韦格纳肉芽肿早期临床症状不典型,易误诊而延误治疗,ANCA或c-ANCA作为韦格纳肉芽肿的血清学标志特异性高,可以帮助早期诊断韦格纳肉芽肿。耳鼻喉科医生应加强对韦格纳肉芽肿在耳部表现的认识,早诊断、早治疗是此病预后的关键因素。
Objective To evaluate the clinical features,diagnosis,treatment,and outcomes of Wegener's granulomatosis with Otologic Manifestations as first symptoms.Methods We retrospectively reviewed3cases of Wegener's granulomatosis with Otologic Manifestations as first symptoms,and refer to relevant literatures of3cases.We evaluated clinical features,the clinical course,diagnosis,treatment,and outcomes in all cases.Results In6cases,the most firstfrequently findings were ear fullness,hearing loss,otalgia,4cases suffered from facial palsy.All cases were misdiagnosed as otitis media and given drug and surgical treatment earlily.Diagnosis of Wegener's granulomatosis was madewhen the patients had clinical findings and positive blood serum markers ANCA or c-ANCA,or when there were typicalpathological manifestations.Immunosuppressive therapy and hormone therapy were the main currently treatment options.Conclusions The early otologic manifestations of Wegener's granulomatosis were so atypical that Wegener's granulomatosiswas misdiagnosed easily,and the treatment was delayed.ANCA or c-ANCA had high specificity in Wegener'sgranulomatosis and were helpful to the diagnosis of Wegener's granulomatosis earlily.Early diagnosis and treatment were the key factors of the prognosis of Wegener's granulomatosis,so ENT doctors should strengthen the awareness of Wegener's granulomatosis in the ear performance.
作者
艾有琴
李子燕
付誉
王国建
AI Youqin;Li Ziyan;FU Yu;WANG Guojian(Department of Otorhinolaryngology,PLA General Hospital;Department of Otorhinolaryngology, Clinical Medicine College Of Southeast University;Department of Otorhinolaryngology,the first people s Hospital of Zhengzhou;Department of Otorhinolaryngology ,the Second Affiliated Hospital of Dalian Medical University)
出处
《中华耳科学杂志》
CSCD
北大核心
2017年第1期61-65,共5页
Chinese Journal of Otology
关键词
韦格纳肉芽肿
中耳炎
听力下降
面瘫
Wegener's granulomatosis
otitis media
hearing loss
facial palsy
