甲泼尼龙琥珀酸钠联合高压氧治疗神经性耳聋患者的临床研究OA北大核心CSTPCD
Clinical trial of methylprednisolone sodium succinate combined with hyperbaric oxygen in nerve deafness patients
目的 比较耳后/鼓室甲泼尼龙琥珀酸钠联合高压氧治疗神经性耳聋患者的临床疗效及安全性.方法 回顾性分析神经性耳聋患者的病例资料,按照队列法分为耳后注射组和鼓室注射组.2组患者均予以高压氧治疗,耳后注射组患者耳后注射甲泼尼龙琥珀酸钠40mg;鼓室注射组患者经鼓膜穿刺注射甲泼尼龙琥珀酸钠40 mg,2组患者均隔日注射1次,共7次.比较2组患者的临床疗效、纯音听阈值、氧化应激及炎症反应指标,并统计药物不良反应发生情况.结果 耳后注射组入组56例、鼓室注射组入组60例.治疗后,耳后注射组和鼓室注射组的总有效率分别为92.86％和88.33％,在统计学上差异无统计学意义(P＞0.05).治疗后,耳后注射组与鼓室注射组的平均纯音听阈分别为(38.49±5.71)和(40.35±6.23)dB,高频区听阈分别为(61.36±6.52)和(63.42±7.09)dB,低频区听阈分别为(59.72±6.85)和(60.81±7.26)dB,超氧化物歧化酶(SOD)水平分别为(112.38±10.72)和(110.43±10.29)U·mL-1,过氧化脂质(LPO)水平分别为(4.69±1.08)和(5.03±1.12)nmol·mL-1,内皮素(ET)分别为(2.11±0.76)和(2.34±0.81)ng·L-1,白细胞介素 6(IL-6)水平分别为(31.79±4.27)和(33.18±4.98)pg·mL-1,C反应蛋白(CRP)水平分别为(5.25±1.48)和(5.72±1.62)mg·L-1,肿瘤坏死因子-α(TNF-α)水平分别为(45.33±4.61)和(46.95±5.24)ng·L-1,在统计学上差异均无统计学意义(均P＞0.05).治疗期间,耳后注射组和鼓室注射组的总药物不良反应发生率分别为23.21％和51.67％,在统计学上差异有统计学意义(P＜0.05).耳后注射组发生局部疼痛11例次、眩晕4例次,鼓室注射组发生局部疼痛30例次、眩晕15例次.结论 耳后/鼓室注射甲泼尼龙琥珀酸钠联合高压氧治疗神经性耳聋临床疗效相当,均可促进患者听力恢复,减轻氧化应激和炎症反应水平,但耳后注射局部疼痛、眩晕发生率更低.
Objective To compare the clinical curative effect of retroauricular and tympanic injection of methylprednisolone sodium succinate combined with hyperbaric oxygen in nerve deafness.Methods A retrospective analysis was performed on the case data with nerve deafness.According to cohort method,they were divided into retroauricular injection group(retroauricular injection of 40 mg methylprednisolone sodium succinate+hyperbaric oxygen therapy)and tympanic injection group(tympanic injection of 40 mg methylprednisolone sodium succinate+hyperbaric oxygen therapy).Both groups were treated for 7 times(once every other day).The curative effect,pure tone hearing threshold,oxidative stress and inflammatory response indexes were compared between the two groups,and adverse reactions were statistically analyzed.Results There were 56 cases in retroauricular injection group and 60 cases in tympanic injection group.There was no significant difference in total response rate between retroauricular injection group and tympanic injection group(92.86％vs 88.33％,P＞0.05).After treatment,average pure tone hearing thresholds in retroauricular injection group and tympanic injection group were(38.49±5.71)and(40.35±6.23)dB;high-frequency hearing thresholds were(61.36±6.52)and(63.42±7.09)dB;low-frequency hearing thresholds were(59.72±6.85)and(60.81±7.26)dB;levels of superoxide dismutase(SOD)were(112.38±10.72)and(110.43±10.29)U·mL-1;levels of lipid peroxide(LPO)were(4.69±1.08)and(5.03±1.12)nmol·mL-1;endothelin(ET)levels were(2.11±0.76)and(2.34±0.81)ng·L-1;interleukin-6(IL-6)levels were(31.79±4.27)and(33.18±4.98)pg·mL-1;levels of C-reactive protein(CRP)were(5.25±1.48)and(5.72±1.62)mg·L-1;levels of tumor necrosis factor-α(TNF-α)were(45.33±4.61)and(46.95±5.24)ng·L-;the difference was not statistically significant(all P＞0.05).During treatment,there were significant differences in total incidence of adverse reactions between retroauricular injection group and tympanic injection group(23.21％vs 51.67％,P＜0.05).There were 11 case times of local pain and 4 case times of vertigo in retroauricular injection group,while there were 30 case times of local pain and 15 case times of vertigo in tympanic injection group.Conclusion Retroauricular injection or tympanic injection of methylprednisolone sodium succinate combined with hyperbaric oxygen therapy has the comparable curative effect in patients with nerve deafness;the two administration modes both can promote hearing recovery,relieve reduce oxidative stress and inflammatory response.However,retroauricular injection has lower incidence of local pain and vertigo.
李瀛;罗蔚锋;卫红齐;李文全;罗颜
苏州大学附属第二医院耳鼻喉科,江苏苏州 215000苏州大学附属第二医院神经内科,江苏苏州 215000
药学
甲泼尼龙琥珀酸钠高压氧神经性耳聋耳后注射鼓室注射临床疗效
methylprednisolone sodium succinatehyperbaric oxygennerve deafnessretroauricular injectiontympanic injectionclinical curative effect
《中国临床药理学杂志》 2024 (003)
345-349 / 5
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