慢性主观性耳鸣患者耳鸣频率与药物治疗效果及预后的关系

Relationship between the tinnitus frequency and the effects of medication and the prognosis in patients with chronic subjective tinnitus

目的了解慢性主观性耳鸣患者耳鸣频率对药物治疗效果及预后的影响。方法对2011年10月至2012年3月就诊的72例（93耳）慢性主观性耳鸣患者进行研究，根据耳鸣匹配检查分为低频组（23耳）、中频组（14耳）和高频组（56耳），所有病例均采用改善微循环＋激素治疗（5％葡萄糖250ml＋银杏叶提取物87．5mg＋地塞米松10mg静脉滴注），3周后评定疗效并对影响预后因素进行相关分析。结果耳鸣患者经药物治疗后痊愈0耳（0％）、显效0耳（0％）、有效18耳（19．4％）、无效75耳（80．6％）。其中低频、中频及高频组的有效率分别为39．1％（9／23）、35．7％（5／14）和7．1％（4／56），高频耳鸣的药物疗效明显差于低频和中频耳鸣，差异有统计学意义（X2=9．919，P=0．002；x2=5．809，P=0．016）；低频耳鸣和中频耳鸣之间的有效率差异无统计学意义（P=0．559）。耳鸣频率的差异对药物治疗的预后有影响（Logistic回归分析，P=0．001）。结论慢性主观性耳鸣患者激素及改善微循环治疗效果欠佳，其中低中频耳鸣的疗效要好于高频耳鸣，耳鸣频率的差异可能是影响其药物疗效及预后的主要因素。

Objective To investigate the influence of tinnitus frequency on medication and prognosis in patients with chronic subjective tinnitus. Methods Seventy-two patients （Ninety-three ears） diagnosed as chronic subjective tinnitus were studied from October 2010 to March 2011. All cases were divided into low frequency （twenty-three ears ）, medium frequency （fourteen ears ） and high frequency （fifty-six ears） according to tinnitus matching test. All cases were treated with microcirculation promotion and steroid therapy （5% glucose 250 ml ＋ ginkgo biloba extract 87. 5 mg ＋ dexamethasone 10 mg intravenous drip）. Curative effect was evaluated and the factors of prognosis were analyzed after three weeks. Results After medication, results were acquired as follows： recovery in 0 ear （0%） , excellent in 0 ear （0%） , effective in 18 ears（ 19.4% ） , invalid in 75 ear（80.6% ）. The effective percentage was 39. 1% , 35.7% and 7.1% , respectively. There was significant difference between these groups, but no significant difference between low frequency and medium frequency. Logistic regression analysis showed that the difference of frequency was significant prognostic factors for medication. Conclusions Microcirculation promotion and steroid therapy had a poor treatment effect in patients with chronic subjective tinnitus. The prognosis of chronic low-medium frequency tinnitus was better than chronic high frequency tinnitns. The difference of frequency retained significant influence on effects and prognosis of medication.