鼓室、耳后骨膜下注射甲泼尼龙琥珀酸钠治疗重度以上突发性耳聋的疗效分析

Efficacy analysis of methylprednisolone sodium succinate injection in the tympanic cavity and behind the ear periosteum in the treatment of sudden deafness of more than severe

目的:探究鼓室、耳后骨膜下注射甲泼尼龙琥珀酸钠(Methylprednisolone sodium succinate,MPSS)治疗重度以上突发性耳聋(Sudden deafness,SD)患者的效果。方法:选取我院2019年2月至2021年5月收治的86例重度以上SD患者,按治疗方案不同分观察组和对照组(n=43)。对照组接受常规治疗,观察组于对照组基础上予以鼓室、耳后骨膜下注射MPSS。对比两组总有效率、听力水平、不良反应发生率,同时采用酶联免疫吸附法测定治疗前、后血清降钙素基因相关肽(Calcitonin gene-related peptide,CGRP)、可溶性血管细胞间黏附因子-1(Soluble vascular cellular adhesion molecules-1,sVCAM-1)水平,采用硝酸还原酶法测定血清一氧化氮(Nitric oxide,NO)水平,采用放射免疫法测定血清内皮素(Endothelin,ET)水平。结果:与对照组相比,观察组总有效率明显提高,治疗1疗程听力水平明显提高,血清CGRP水平明显升高,血清sVCAM-1、NO、ET水平明显降低(P<0.05),而两组不良反应总发生率未见明显差异(P>0.05)。结论:鼓室、耳后骨膜下注射MPSS重度以上SD患者可进一步提升疗效,调节血清CGRP、sVCAM-1、NO、ET水平,改善听力水平,安全性高。

Objective:To investigate the effect of Methylprednisolone sodium succinate(MPSS)injection under the tympanic cavity and behind the ear periosteum in the treatment of patients with more severe sudden deafness(SD).Methods:A total of 86 severe or above SD patients who were admitted to our hospital from February 2019 to May 2021 were selected and divided into observation group and control group according to different treatment plans(n=43).The patients in control group received conventional treatment,and the patients in observation group received MPSS injection on the basis of the control group.The total effective rate and hearing level were measured,serum calcitonin gene-related peptide(CGRP),soluble vascular cellular adhesion molecules-1(sVCAM-1)were determined by enzyme-linked immunosorbent assay;nitric oxide(NO)and endothelin(ET)level were determined by nitrate reductase method and radioimmunoassay,respectively.Results:Compared with control group,the total effective rate of the observation group was significantly increased,the hearing level in one course of treatment was significantly improved,the serum CGRP level was significantly increased,and the serum sVCAM-1,NO and ET levels were significantly decreased(P<0.05)and there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Subtympanic and retroperiosteal injection of MPSS can further improve the curative effect,regulate the levels of serum CGRP,sVCAM-1,NO,and ET,and improve the hearing level,with high safety.