感音神经性听力损失与磷酸二酯酶-5抑制剂：一项系统综述。

文献信息

中文摘要

引言： 突发性感音神经性听力损失（SSNHL）可显著影响生活质量。近期研究提出使用磷酸二酯酶-5抑制剂（PDE-5is）与SSNHL发生之间存在关联。
目的： 阐明PDE-5i使用与SSNHL发生风险之间的关系。
数据综合： 遵循系统综述和荟萃分析首选报告条目（PRISMA）声明，两名独立评审员检索了PubMed、Embase和Web of Science数据库中截至2023年12月关于PDE-5i使用者听力损失的文章。在最初识别的190篇摘要中，有6篇符合纳入标准，共计54名患者，年龄在37至62岁之间。一项研究涉及4名女性参与者，其余研究则聚焦于50名男性患者。西地那非、伐地那非和他达拉非是最常用的PDE-5is。所有患者均出现感音神经性听力损失，程度从中度到极重度不等，除听力损失外，4名患者（7%）注意到耳鸣，3名患者（5%）出现眩晕。一名患者在开始服用西地那非15天后出现双侧听力损失。皮质类固醇治疗是所有病例中唯一的治疗方法。在7例中可获得停药后的长期结局：4名患者（57%）无改善，2名患者（29%）完全恢复，1名患者（14%）的听力损失未完全消退。
结论： 本系统综述强调了监测PDE5i患者听力并向其告知潜在风险的重要性。需要更大样本和对照组的进一步研究来确定明确的因果关系。

英文摘要

INTRODUCTION: Sudden sensorineural hearing loss (SSNHL) can significantly impact quality of life. Recent studies propose a link between the use of phosphodiesterase-5 inhibitors (PDE-5is) and SSNHL emergence.
OBJECTIVE: To clarify the relationship between PDE-5i use and the risk of SSNHL development.
DATA SYNTHESIS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, two independent reviewers searched the PubMed, Embase, and Web of Science databases for articles up to December 2023 on hearing loss in PDE-5i users. Out of 190 abstracts initially identified, 6 met the inclusion criteria, totaling 54 patients aged between 37 and 62 years. One study involved 4 female participants, while the rest focused on 50 male patients. Sildenafil, vardenafil, and tadalafil were the most commonly used PDE-5is. All patients experienced sensorineural hearing loss, ranging from moderate to profound, with 4 patients (7%) noting tinnitus and 3 patients (5%), vertigo, in addition to the hearing loss. One patient experienced bilateral hearing loss 15 days after initiating sildenafil consumption. Corticosteroid therapy was the exclusive treatment in all cases. The long-term outcomes following the cessation of the medication were available in 7 cases: 4 patients (57%) had no improvement, 2 patients (29%) fully recovered, and 1 patient (14%) had incomplete resolution of the hearing loss.
CONCLUSION: The current systematic review underscores the importance of monitoring hearing in PDE5i patients and advising them about the potential risk. Further research with larger samples and control groups is needed to establish a definitive causal link.