【摘要】 目的:探讨慢性粒细胞白血病(CML)出现耳聋的可能发病机制。方法:报告1例以双侧耳聋为首发症状的CML的临床资料,并复习文献。结果:CML突发耳聋可发生在CML各个时期,或双侧或单侧,可伴有极高的外周血白细胞,并可出现头颅CT或MRI的异常,快速降低的白细胞和鞘内化疗可使部分病例耳聋呈逆转趋势。结论:CML患者耳聋的发生机制可能与高白细胞血症、高黏度血症、白血病细胞浸润、内耳出血有关。青少年CML患者的耳聋可能是因为高白细胞血症所致,治疗上可采用白细胞单采法,亦可加用氨甲喋呤鞘内注射。更多还原

【Abstract】 Objective:To study the pathogenesis of hearing loss in chronic myelogenous leukemia (CML).Method:To report one case with CML whose first sign was sudden bilateral hearing loss,and discuss the pathogenetic mechanisms by reviewing literature.Result:Hearing loss,unilateral or bilateral,can be found in different phrases in CML and presented with dramatic high white blood cell count in peripheral blood and abnormal finding in computed tomography (CT) or magnetic resonance imaging (MRI). Some cases of sudden hearing loss in CML may be improved or even reversed by leukapheresis and intrathecal chemotherapy.Conclusion:The proposed pathogenesis for deafness in leukemia is due to hyperleukocytosis,hyperviscosity syndrome,leukemic infiltration and the inner ear hemorrhage. The probable mechanism for young patients with CML is hyperleukocytosis,and such patients can be treated with leukapheresis. Preventive intrathecal methotrexate could be done.更多还原