目的:探讨内皮素-1(ET-1)和一氧化氮(NO)与糖尿病听力损害的关系.方法:共入选88例2型糖尿病患者,所有患者通过相关临床并发症检查排除糖尿病伴视网膜、肾脏及神经病变,并取同期53例正常人群作为对照.对每位患者进行纯音测听判断是否存在听力损害.分别以放射免疫法及硝酸还原酶法检测所有对象血浆ET-1和血清NO水平.结果:糖尿病伴听力损害患者血浆ET-1显著增高(P<0.01),血清NO水平显著下降(P<0.05).多因素logistic回归分析发现高糖化血红蛋白(HbA1c)(OR:4.525,P<0.05)、高低密度脂蛋白胆固醇(LDL-C) (OR:2.381,P<0.05)、高血浆ET-1(OR:6.207,P<0.01)和低血清NO(OR:0.862,P<0.05)是糖尿病听力损害的独立危险因素.结论:糖尿病相关听力损害发生可能早于其它并发症,高血糖、高血脂、高血浆ET-1及低血清NO水平与糖尿病听力损害的发生密切相关.%AIM:To evaluate the relationship between endothelin - 1 (ET- 1)/nitric oxide (NO) and hearing impairment in type 2 diabetes mellitus ( DM). METHODS: Eighty - eight type 2 diabetic patients with no signs of microangiopathy (retinopathy and nephropathy) or peripheral neuropathy, and 53 healthy subjects in the same period were enrolled in this study. Auditory function was evaluated using pure tone audiometry. Totally, type 2 DM group (n = 88) and normal control group (NC, n = 53 ) were divided into subgroups based on the presence and absence of hearing impairment. The concentration of plasma ET -1 was detected by radioimmunoassay. The concentration of serum NO was measured by the method of nitric acid reductase. RESULTS: Significantly increased plasma ET - 1 and decreased serum NO were observed in diabetic patients with hearing impairment compared with those in diabetic patients without hearing impairment. The results of multivariate logistic regression analysis showed that hearing impairment in type 2 DM group was significantly associated with elevated level of HbAlc (OR =4.525, P<0.05), LDL-C (Oft =2.381 ,P<0.05) and plasma ET-1 ( OR = 6.207, P < 0.01). Besides, elevated serum level of NO (Or = 0.862, P < 0.05 ) was associated with lower risk of hearing impairment in diabetics. CONCLUSION: Hearing impairment may happen earlier than other complications in diabetic patients. In addition to hyperglycemia and hyperlipemia, high level of ET -1 and low levels of NO might contribute to hearing impairment in diabetic patients.
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