不同剂量糖皮质激素在急性低频下降型感音神经性聋治疗中的疗效差异

Outcome in patients with acute low-tone sensorineural hearing loss by administration of different doses of glucocorticoids

目的:探讨不同剂量糖皮质激素在治疗急性低频下降型感音神经性聋(ALHL)中的疗效差异。方法:选取54例(54耳)ALHL患者,随机分为无泼尼松组(10例)、低剂量泼尼松组(22例)和高剂量泼尼松组(22例),治疗10d,并随访6个月。结果:无泼尼松组、低剂量泼尼松组和高剂量泼尼松组痊愈率分别为30.0%、59.1%、90.9%,高、低剂量组比较差异有统计学意义(P<0.05);改善率分别为40.0%、86.4%、95.5%,低剂量、高剂量泼尼松组与无泼尼松组比较均差异有统计学意义(均P<0.05)。结论:用糖皮质激素治疗ALHL疗效显著,高剂量优于低剂量,提示该病与内淋巴水肿和患者自身免疫机制可能相关。

Objective：Aimed to compare the outcome in patients with acute low-tone sensorineural hearing loss（ALHL） treated with different doses of glucocorticoids.Method：Fifty-four ALHL patients were randomly divided into no-prednisone group（n=ten）,low-dose prednisone group（n=22）and high-dose prednisone group（n=22）.All patients were treated for ten days and followed up for six months from the initial examination.Result：The cure rates（complete recovery）were 30.0%,59.1%,90.9% respectively and the improved rates（complete recovery and partial recovery） were 40.0%,86.4%,95.5% respectively in the three groups of no prednisone group,low-dose prednisone group and high-dose prednisone group.The low-dose prednisone group therapy for ALHL showed significant improved rates than the no prednisone group（P0.05）.The high-dose prednisone group therapy for ALHL showed significant cure rates than the low-dose prednisone group（P0.05）.Conclusion：High-dose glucocorticoids is more effective than low dose.It is suggested that the etiology of ALHL is related with both an endolymphatic hydrops and an autoimmunological mechanism.