Article record

幼年特发性关节炎中的传导性和感音神经性听力损害：一项系统综述与荟萃分析

Conductive and sensorineural hearing impairment in juvenile idiopathic arthritis: a systematic review and meta-analysis.

综述 Meta耳科IF 5.1Q1

文献信息

PMID	42949086
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Shih-Huan Chen 查看其他 6 位作者 Yung-Hsuan Lee；Ching-Yuan Wang；Tang-Chuan Wang；Fang-Wei Lin；Chia-Der Lin；Po-Chang Wu
作者单位	Department of Education, China Medical University Hospital, Taichung 404332, Taiwan. 查看其他 5 条单位信息 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan.；Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 404332, Taiwan.；Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.；Department of Master Program for Biomedical Engineering, College of Biomedical Engineering, China Medical University, Taichung, Taiwan.；Division of Rheumatology and Immunology, Department of Internal Medicine, China Medical University Hospital, Taichung 404332, Taiwan.
期刊	Rheumatology (Oxford, England)
SCI 分区	Q1
IF	5.1
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

目的： 确定幼年特发性关节炎（JIA）患者与健康对照相比，听骨链僵硬和耳蜗功能障碍的患病率。
方法： 我们检索了PubMed（1966年至2025年12月27日）、Embase（1947年至2025年12月27日）和Cochrane对照试验中心注册库（1996年至2025年12月27日）。选择诊断为JIA并接受听力学检查（耳蜗和中耳功能）的患者研究纳入本综述。采用随机效应模型计算合并相对危险度（RR）和标准化均数差（SMD）。
结果： 共纳入7项研究（237例JIA患者；132例健康对照）；其中6项被判定为方法学质量高（Newcastle-Ottawa评分≥8）。JIA患儿As型鼓室图患病率显著更高（RR=13.93，95%CI 5.83-33.27），纯音听阈升高，最大效应见于16 kHz扩展高频（SMD=1.52，95%CI 1.04-1.99）。JIA中合并的耳声发射振幅呈降低趋势，但未达到统计学显著性（SMD=-1.72，95%CI -8.77至5.33；I²=96%），尽管唯一报告DPOAE的研究提示明显降低。
结论： JIA与可量化的双腔室听力学负担相关——机械性中耳僵硬风险显著升高，以及以超出常规听力范围最为明显的频率依赖性感音神经性缺陷。鼓室压测量和扩展高频测听可能为检测JIA亚临床听觉受累提供互补信息。OAE（包括DPOAE）的潜在作用需要在更大规模的前瞻性研究中确认。

英文摘要

OBJECTIVES: To determine the prevalence of ossicular stiffness and cochlear dysfunction in patients with juvenile idiopathic arthritis (JIA) compared with healthy controls.
METHODS: We searched PubMed (1966-27 December 2025), Embase (1947-27 December 2025), and the Cochrane Central Register of Controlled Trials (1996-27 December 2025). Studies of patients diagnosed with JIA who underwent audiological examinations (cochlear and middle ear function) were selected for the review. Random-effects models were used to calculate pooled relative risks (RR) and standardized mean differences (SMD).
RESULTS: Seven studies (237 patients with JIA; 132 healthy controls) were included; six were judged high methodological quality (Newcastle-Ottawa score ≥ 8). Children with JIA exhibited a markedly higher prevalence of type As tympanograms (RR = 13.93, 95% CI 5.83-33.27) and elevated pure-tone hearing thresholds, with the largest effect observed at the extended high frequency of 16 kHz (SMD = 1.52, 95% CI 1.04-1.99). Pooled otoacoustic emission amplitudes trended lower in JIA but did not reach statistical significance (SMD = -1.72, 95% CI - 8.77 to 5.33; I² = 96%), although the single study reporting DPOAE suggested a marked reduction.
CONCLUSION: JIA is associated with a quantifiable dual-compartment audiological burden-a markedly elevated risk of mechanical middle-ear stiffness and a frequency-dependent sensorineural deficit most pronounced beyond the conventional audiometric range. Tympanometry and extended high-frequency audiometry may provide complementary information for detecting subclinical auditory involvement in JIA. The potential role of OAEs, including DPOAE, requires confirmation in larger prospective studies.