血浆纤维蛋白原水平对溶栓治疗突发性聋疗效评价

Plasma fibrinogen level on fibrinolytic therapy effect assessment sudden deafness

目的观察血浆纤维蛋白原水平(FIB)对溶栓治疗突发性聋患者的疗效影响,评价其重要性,进而推进临床上对突发性聋的治疗进展。方法选取我院2007年3月～2010年3月收治的突发性聋患者108例,根据血浆纤维蛋白原水平平均分为血浆纤维蛋白原正常组(纤维蛋白原≤3.5 g/L,54耳)和血浆纤维蛋白原升高组(纤维蛋白原>3.5 g/L,54耳),各54例,两组患者同时给予巴曲酶溶栓滴注治疗,治疗前及治疗后7 d,检测患者的纯音听阈,对两组患者治疗前后结果进行分析比较。疗程期间密切观察患者的皮肤或黏膜处是否有出血点。结果在各疗程结束后,血浆纤维蛋白原水平正常组的患者,通过溶栓治疗,痊愈1例,显效3例,有效9例,无效41例,总有效率为24.1%;血浆纤维蛋白原水平升高组的患者,痊愈6例,显效15例,有效23例,无效10例,总有效率为81.5%。血浆纤维蛋白原水平升高组的治疗总有效率明显高于血浆纤维蛋白原正常组,且差异有高度统计学意义(P<0.01)。结论对于血浆纤维蛋白原水平升高的突发性聋患者,采用降纤溶栓的治疗方法,更为有效、高效,对于血浆纤维蛋白原水平正常的突发性聋患者,应尽量采用其他疗法,以免耽误病情。

Objective To observe the level of plasma fibrinogen（FIB） for thrombolytic treatment of sudden deafness treatment of patients with sudden deafness evaluate the effect of its importance,and thus promote the clinical treatment of sudden deafness progress.Methods 108 patients in our hospital from March 2007 to March 2010 were treated with sudden deafness,and were divided into normal plasma fibrinogen group（fibrinogen≤3.5 g/L,54 ears） and elevated plasma fibrinogen group（fibrinogen3.5 g/L,54 ears） respectively according to plasma fibrinogen levels.Of the 54 cases,two groups of patients were also given Batroxobin thrombolytic infusion therapy.Before treatment and 7 days after treatment,the pure tone audiometry of patients was detected.The results of two groups before and after treatment were analyzed and compared.During the course of close observation of the patient＇s skin or mucous membranes at whether there was bleeding.Results After the end of treatment,plasma fibrinogen levels in patients with normal group,by thrombolytic therapy were cured in 1 case,excellent in 3 cases,effective in 9 cases,invalid in 41 cases,the total efficiency of 24.1%,plasma fibrinogen elevated levels of the original group of patients cured in 6 cases,excellent in 15 cases,effective in 23 cases,invalid in 10 cases,the total efficiency of 81.5%.Elevated level of plasma fibrinogen treated group was significantly higher than normal plasma fibrinogen group,and the difference was statistically significant.Conclusion For the plasma fibrinogen level in patients with sudden deafness,the use of fibrinolytic thrombolytic treatment is more effective,efficient.And for normal levels of plasma fibrinogen in patients with sudden deafness,they should be adopted in other therapy,so as not to delay the disease.