热休克蛋白70抗体检测对自身免疫性聋诊断的意义

目的 分析自身免疫性聋的听力学特点，探讨用免疫印迹法(Western blot)检测热休克蛋白70抗体在自身免疫性耳聋诊断中的意义。方法自身免疫性聋14例28耳，其它感音神经性聋8例16耳，正常对照6例12耳，采用免疫印迹法检测各组受试者血清中的热休克蛋白70抗体，并分别作临床听力学检查。结果自身免疫性耳聋者纯音听力图多数为平坦型，TEOAE和／或DPOAE未引出，听性脑干反应多数正常，轻、中度耳聋者可引出镫骨肌声发射，该组8例(57．1％)热休克蛋白70抗体阳性。其它感音神经性聋者纯音听力图多数为高频减退型和平坦型，TEOAE和DPOAE未引出，重度耳聋者ABR未引出，轻、中度耳聋者可引出镫骨肌声发射，1例(12．5%)热休克蛋白70抗体阳性。正常对照组1例(16．7％)热休克蛋白70抗体阳性。结论免疫印迹法检测热休克蛋白70抗体对自身免疫性耳聋诊断有参考价值，对该病的确诊还应结合临床听力学特点。

Diagnostic Utility of Western Blot for HSP 70 in Autoimmune Inner Ear Disease

Objective To assess the diagnostic utility of western blot for hsp 70 in autoimmune inner ear disease.Methods Western blot for Hsp 70 and audiologic findings auditory brainstem response(ABR), evoked otoacoustic emission ( EOAE), et al] of 14 cases with autoimmune inner ear disease (AIED),8 cases with retrocochlear low frequency hearing loss,8 cases with other sensorineural hearing loss and 6 normal controls were studied.Results The audiologic findings showed normal ABR and no EOAE in AIED. The typical clinical manifestations of retrocochlear low frequency hearing loss were normal EOAE, which could not be suppressed by contralateral white noise, abnormal ABR and no acoustic reflex. Among 14 cases of AIED, 8(57.1%) were positive of hsp-70 antibody in their sera. Among 8 cases of retrocochlear low frequency hearing loss, 4(50.0%) were positive of hsp-70 antibody in their sera. Hsp-70 antibody was also found in one case of hereditary hear loss and one normal control.Conclusion The results of present study indicated that, in addition to audiologic findings, the western blot for hsp 70 is helpful in diagnosis of autoimmune inner ear disease.