梅尼埃病治疗的最新进展:综述

G. Panagiotopoulos
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摘要

梅尼埃氏病(MD)是一种慢性异质性疾病,最近发现涉及几个基因的多种罕见和常见变异。它几乎总是需要持续一段时间的管理。治疗选择侧重于改善MD患者的生活质量。控制并不总是容易的,需要多种药物治疗,甚至外科手术。偏头痛、血脂异常、肥胖、糖尿病、睡眠呼吸暂停、高血压和动脉粥样硬化是与MD相关的主要疾病,通常需要医疗管理。偏头痛的预防和诱因消除、镁补充、低钠摄入、利尿剂、抗凝血剂和抗高血压药是最初使用的治疗方法。如果药物控制无效,可口服或腹腔注射类固醇。消融仍然是治疗失败的单侧病例的最终治疗方法,因此有助于定制前庭康复方案。尤其在考虑家族性MD时,应进行遗传学研究。适当的基因变异靶向治疗可以在不久的将来为潜在的基因治疗提供候选药物。
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Current Perspectives in Meniere’s Disease Treatment: A Mini Review
Meniere’s disease (MD) is a chronic heterogeneous disorder recently found to involve multiple rare and common variants in several genes. It almost always necessitates management for a sustained period of time. Treatment options focus on improving quality of life in MD patients. Control is not always easy to achieve, requiring multidrug treatments, and even surgical procedures. Migraine, dyslipidemia, obesity, diabetes, sleep apnea, hypertension, and atherosclerosis are among the major diseases that are associated with MD and often require medical management. Migraine prophylaxis and trigger elimination, magnesium supplementation, low sodium intake, diuretics, anticoagulants, and antihypertensives are among the treatments used initially. Steroids administered orally or intratympanically are used if medical control is not beneficial. Ablation remains the definitive treatment in unilateral cases experiencing management failure, thus facilitating a customized vestibular rehabilitation protocol. Genetic study should be implemented especially when familial MD is considered. Proper gene variance targeting in MD can provide in the immediate future candidates for potential gene therapy.
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