血清同型半胱氨酸和血栓素B2水平与突发性聋的相关性研究

Study on the correlation between serum homocysteine,thromboxane B2 levels and sudden deafness

目的探讨血清同型半胱氨酸(tomocysteine,Hcy)和血栓素B2(thromboxane B2,TXB2)水平与突发性聋发病及疗效的相关性。方法选取60例突发性聋患者,随机分为治疗组和实验组,另选60例健康人为对照组,均行听力学检查,并检测血清Hcy和TXB2;实验组在治疗组治疗方案基础上口服叶酸。结果突发性聋患者血清Hcy和TXB2较正常人明显升高(t Hcy=215.553,t TXB2=111.616,P<0.01);治疗后二者水平均明显下降(t治疗组Hcy=5.523,t实验组Hcy=6.946,t治疗组TXB2=3.141,t实验组TXB2=4.587,P<0.01),且实验组明显低于治疗组(tHcy=45.354,t TXB2=16.932,P<0.01);实验组听力改善有效率(90%)及显效率(70%)与治疗组(86.7%和56.7%)无统计学差异(P>0.05);两组患者血清Hcy和TXB2在P=0.01水平上呈显著正相关(r=0.639)。结论高Hcy和TXB2可能是突发性聋发病的高危因素;叶酸对高Hcy和TXB2有治疗作用,对听力改善作用有待进一步研究;高TXB2很可能是高Hcy致突发性聋发病的重要途径。

OBJECTIVE To explore the correlation between serum levels of homocysteine(Hcy),thromboxane B2(TXB2)and the pathogenesis and treatment efficacy of sudden deafness(SD).METHODS 60 patients with SD were randomly divided into treatment group and experimental group.Another 60 healthy persons were selected as the control group.Audiometry was performed and the serum levels of TXB2 and Hcy were detected.In experimental group,folic acid was taken orally in addition to the treatment protocols of treatment group.RESULTSThe serum levels of Hcy and TXB2 at the patients with SD were significantly higher than those of the normal adults(tHcy=215.553,tTXB2=111.616,P<0.01).The levels of Hcy and TXB2 were significantly decreased after the treatment(t Treatment Group Hcy=5.523,t Experimental GroupHcy=6.946,t Treatment GroupTXB2=3.141,t Experimental Group TXB2=4.587,P<0.01),and the descent in the experimental group was much more than that of the treatment group(t Hcy=45.354,t TXB2=16.932,P<0.01).There was no significant difference in the effective rate and obvious effective rate of hearing improvement between the experimental group(90%,70%)and the treatment group(86.7%,56.7%,P>0.05).In both groups,the serum levels of Hcy and TXB2 were in positive correlation at the 0.01 level(r=0.639).CONCLUSION The elevated serum level of Hcy and TXB2 is probably the high risk factor of SD.Folic acid has therapeutic effect on high level of Hcy and TXB2.But its effect on hearing improvement still needs further study.High TXB2 level may be one of the important mechanisms of hyperhomocysteinemia-induced SD.