摘要
目的探讨甲泼尼松龙琥珀酸钠联合复方甘草酸苷药物在耳后注射给药方法在突发性耳聋患者中的临床效果。方法选取2020年1月至2022年6月门诊就诊的120例突发性耳聋患者为研究对象,随机数字表法分为两组,每组60例。两组均给予常规方法治疗,对照组采用耳后注射甲泼尼松龙琥珀酸钠治疗,观察组采用耳后注射甲泼尼松龙琥珀酸钠联合复方甘草酸苷治疗,比较两组纯音听阈值、血液流变学水平、同型半胱氨酸(Hcy)、D-二聚体(D-D)、耳内微循环、T淋巴细胞水平、药物安全性及复发率。结果观察组干预前后0.5、1、2及4 kHz下纯音听阈平均值的差值均好于对照组(P<0.01);观察组治疗2周后全血高切黏度、低切黏度、血浆黏度、Hcy及D-D干预前后平均值的差值均大于对照组(P<0.01);观察组治疗2周后脂质过氧化物(LPO)、胱抑素C(CysC)和内皮素(ET)水平低于对照组(P<0.01);超氧化物歧化酶(SOD)水平高于对照组(P<0.01);观察组治疗2周后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)平均值在干预前后差值均好于对照组(P<0.01);CD8^(+)水平低于对照组(P<0.05);两组治疗过程中咽鼓管损伤、逆行感染、耳部不适、低血钾、高血压发生率差异无统计学意义(P>0.05);观察组随访6个月复发率低于对照组(P<0.05)。结论耳后注射甲泼尼松龙琥珀酸钠联合复方甘草酸苷用于突发性耳聋患者中,能降低纯音听阈值,有助于改善患者血液流变学水平和耳内微循环,降低Hcy及D-D水平,可调节患者T淋巴细胞水平,且药物安全性较高,能降低远期复发率,值得推广应用。
Objective To evaluate the clinical efficacy of methylprednisolone sodium succinate combined with compound glycyrrhizin administered through postauricular injection in patients with sudden hearing loss.Methods One hundred and twenty patients with sudden sensorineural hearing loss who visited the outpatient clinic from January 2020 to June 2022 were randomly divided into two groups using a random number table,with 60 cases in each group.Both groups received conventional treatment,and the control group was treated with postauricular injection of methylprednisolone sodi-um succinate.The observation group was treated with postauricular injection of methylprednisolone sodium succinate com-bined with compound glycyrrhizin.The two groups were compared in terms of pure-tone thresholds,hemorheological pa-rameters,homocysteine(Hcy),D-dimer(D-D),inner ear microcirculation,T lymphocyte levels,drug safety,and recurrence rate.Results The differences in the average values of pure-tone threshold at 0.5,1,2,and 4 kHz before and after intervention in the observation group were better than those in the control group(P<0.01).Two weeks after treatment,the differences in the average values of whole blood high shear viscosity,low shear viscosity,plasma viscosity,Hcy,and D-D before and afer intervention in the observation group were greater than those in the control group(P<0.O1).Two weeks after treatment,the levels of LPO,CysC,and ET in the observation group were lower than those in the control group(P<0.01),while the SOD level was higher than that in the control group(P<0.01).Two weeks after treatment,the differences in the average values of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)before and after intervention in the observation group were higher than those in the control group(P<0.01),while the CD8^(+)level was lower than that in the control group(P<0.05).There was no statistically significant difference in the incidence of eustachian tube damage,ret-rograde infection,ear discomfort,hypokalemia,and hypertension between the two groups during treatment(P>0.05).The recurrence rate in the observation group was lower than that in the control group at the 6-month follow-up(P<0.05).Conclusion Postauricular injection of methylprednisolone sodium succinate combined with compound glycyrrhizin for sudden sensorineural hearing loss can reduce pure-tone thresholds,improve hemorheological parameters and inner ear microcirculation,lower Hcy and D-D levels,regulate T lymphocyte levels,exhibit high drug safety,and reduce the long-term recurrence rate.It is worthy of promotion and application.
作者
何建珉
陆雷芸
赵影颖
兰四海
朱笛
HE Jian-min;LU Lei-yun;ZHAO Ying-yin;LAN Si-hai;ZHU Di(Department of Otorhinolaryngology,Shanghai Ninth People's Hospital(Huangpu Branch)Affilia ted to Medical College of Shanghai Jiaotong University,Shanghai 20001l,China)
出处
《广东医学》
CAS
2024年第3期371-375,共5页
Guangdong Medical Journal
基金
上海市黄浦区卫生健康系统科研项目(HLM202209)。
关键词
耳后注射
甲泼尼松龙琥珀酸钠
复方甘草酸苷
突发性耳聋
耳内微循环
纯音听阈值
血液流变学
postauricular injection
methylprednisolone succinate sodium
compound glycyrhizin injection
sudden hearing loss
inner ear microcirculation
pure tone threshold
blood rheology
