地塞米松治疗突发性聋

The clinical study of dexamethasone in treatment of sudden hearing loss and the influence on nitric oxide and glutathione peroxidase

目的对地塞米松(dexamethasone,DM)等综合治疗突发性聋的疗效进行临床观察及探讨一氧化氮(nitricoxide,NO)和谷胱甘肽过氧化物酶(glutat-hioneperoxidase,GSH-px)与突发性聋的关系。方法将本院60例突发性聋患者按就诊顺序随机分为DM治疗组30例(35耳)和非DM治疗组30例(36耳)。DM组采用DM治疗,非DM组采用生理盐水治疗;两组同时采用ATP等其它相同的治疗。30名健康志愿者做对照。两组在治疗前后做纯音测听及检测NO、GSH-px。结果DM组和非DM组治疗前患耳气导平均听阈分别为(70.34±18.02)dBHL和(71.23±17.45)dBHL(t=0.175,P>0.05);治疗后DM组30例中痊愈17例(21耳)、显效8例(8耳)、有效3例(4耳)、无效2例(2耳),治愈率60%;非DM组30例中痊愈6例(6耳)、显效8例(9耳)、有效10例(15耳)、无效6例(6耳),治愈率16.67%。两组经统计学处理差异有显著性(x2=13.49,P<0.01)。NO和GSH-px的检测结果:两组治疗前后比较及治疗前后与对照组比较差异均有显著性,按本实验剂量应用未发现明显副作用。结论DM治疗突发性耳聋的效果肯定,可应用于临床工作。

OBJECTIVE To investigate the effect of dexamethasone on sudden hearing loss and on serum level of nitric oxide and glutathione peroxidase. METHODS Sixty cases of sudden hearing loss were randomly divided into DM group with 30 cases （n=35 ears） and placebo group with 30 cases （n=36 ears）. Aside from intravenous administration of dexamethasone to DM group and physiological saline to placebo group, treatments including energy preparation such as ATP, CoA, CTP, vitamin C and hyperbaric oxygen, a vasodUator, were the same. There were 30 healthy volunteers in the control group. RESULTS The hearing threshold was （70.34 ± 18.02） dB HL in the DM group and （71.23 ± 17.45） dB HL in the placebo group （P〉0.05） before treatment. After treatment, the hearing thresholds were recovered in 21 ears, significantly improved in 8 ears, improved in 4 ears and not changed in 2 ears in the DM group. In placebo group, the hearing threshold was recovered in 6 ears, significantly improved in 9 ears, improved in 15ears and not changed in 6 ears after treatment. There was a significant difference in the level of hearing improvement between the DM group and the placebo group（x^2=13.49, P〈0.01）. CONCLUSION The application of DM can significantly improve the hearing of patients with sudden hearing loss. DM can improve the microcirculation of inner ear.