长春西汀联合巴曲酶对老年2型糖尿病伴耳聋患者听力、血糖及血清visfatin与ENA-78水平的影响

Effects of vinpocetine combined with batroxobin on blood glucose,hearing,and serum levels of visfatin and ENA-78 in elderly patients with type 2 diabetes mellitus and deafness

目的探讨长春西汀联合巴曲酶对老年2型糖尿病伴耳聋患者听力、血糖及血清visfatin与ENA-78水平的影响。方法选取2016年7月至2019年7月我院收治的94例老年2型糖尿病伴耳聋患者,按随机数表法分为观察组与对照组,每组47例。所有患者均予降糖、改善耳蜗微循环、营养神经等基础治疗。对照组应用巴曲酶注射液,静脉滴注,10 BU/次,2天1次,连续治疗10 d。观察组在对照组基础上联合长春西汀,静脉滴注,20 mg/次,2天1次,连续治疗10 d。比较两组总有效率、治疗前后不同时间点的空腹血糖与纯音听阈值、治疗前后的血清visfatin与ENA-78及全血高切黏度、全血低切黏度及血浆黏度。并分析纯音听阈值与血清visfatin与ENA-78的相关性。结果观察组总有效率(89.36%)高于对照组(72.34%)(P<0.05)。两组治疗前的空腹血糖相当(P>0.05),治疗后不同时间点,两组空腹血糖均较治疗前降低(P<0.05),但组间差异无统计学意义(P>0.05),且两组治疗期间均未见低血糖事件。治疗后不同时间点,两组的纯音听阈值较治疗前降低(P<0.05)。观察组治疗后8 d、10 d的纯音听阈值分别为(52.60±3.11)dB、(48.42±2.02)dB,低于对照组(55.71±3.32)dB、(52.61±2.97)dB,差异有统计学意义(P<0.05)。治疗10 d后,两组血清visfatin与ENA-78、全血高切黏度、全血低切黏度、血浆黏度均较治疗前降低(P<0.05),且观察组下降幅度大于对照组(P<0.05)。纯音听阈值与血清visfatin之间呈明显正相关(r=0.75,P<0.001),与血清ENA-78之间呈明显正相关(r=0.72,P<0.001)。两组不良反应发生率的差异无统计学意义(P>0.05)。结论巴曲酶联合长春西汀治疗老年2型糖尿病伴耳聋可发挥协同作用,促进患者血液流变学的改善,并下调血清visfatin、ENA-78,促进患者听力的恢复,疗效优于单一巴曲酶,且具有较高安全性。

Objective To investigate the effects of vinpocetine combined with batroxobin on hearing,blood glucose,and serum levels of visfatin and ENA-78 in elderly patients with type 2 diabetes mellitus and deafness.Methods A total of 94 elderly patients with type 2 diabetes mellitus with deafness receiving treatment from July 2016 to July 2019 were randomly divided into observation group and control group by random number table method,47 cases each.All patients received hypoglycemc treatment and the basic treatment of improved cochlear microcirculation and nerve nutritional.Both groups were treated with batroxobin injection by intravenous driping 10 BU/time,once every 2 days,for 10 days.The observation group was additionally treated with vinpocetine by intravenous infusion,20 mg/time,once every 2 days,for 10 days.The total effective rate,fasting blood glucose and pure tone threshold at different time points before and after treatment,serum levels of visfatin and ENA-78 before and after treatment,high-cut viscosity of whole blood,low-cut viscosity of whole blood and plasma viscosity were compared.The correlation between pure tone threshold and serum levels of visfatin and ENA-78 was analyzed.Results The total effective rate of observation group was 89.36%,which was higher than 72.34%of the control group(P<0.05).The fasting blood glucose before treatment was comparable between the two groups(P>0.05).At different time points after treatment,the fasting blood glucose of the two groups was lower than that before treatment(P<0.05),but the difference between the two groups was not statistically significant(P>0.05),and no hypoglycemia events were observed during the treatment.At different time points after treatment,the pure tone hearing threshold of the two groups was lower than that before treatment(P<0.05).The pure tone thresholds of the observation group at 8 and 10 days after treatment were(52.60±3.11)dB,(48.42±2.02)dB,which were lower than those of the control group[(55.71±3.32)dB,(52.61±2.97)dB]with statistical significance(P<0.05).After 10 days of treatment,serum visfatin and ENA-78,whole blood high-cut viscosity,whole blood low-cut viscosity and plasma viscosity of the two groups were lower than those before treatment(P<0.05),and the decrease of the observation group was even larger(P<0.05).There was a significant positive correlation between pure tone threshold and serum visfatin(r=0.75,P<0.001),and a positive correlation with serum ENA-78(r=0.72,P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Batroxobin combined with vinpocetine can play a synergistic role in the treatment of elderly type 2 diabetes with deafness,promoting the improvement of blood rheology and down-regulating serum visfatin,ENA-78,which promotes the recovery of hearing.Its effect is better than single batroxobin,and has higher security.