鼓室内注射与静脉滴注泼尼松龙治疗突发性聋的疗效比较

Efficacy of intratympanic injection versus intravenous drip of prednisolone acetate in the treatment of sudden hearing loss

目的比较鼓室内注射与静脉滴注泼尼松龙(PAI)治疗突发性聋(SHL)的临床疗效。方法选取2017年1月至2020年1月宁波明州医院耳鼻喉科收治的SHL患者120例为研究对象,根据用药途径不同分为鼓室组(鼓室内注射PAI,n=60)和静脉组(静脉滴注PAI,n=60)。两组患者均持续治疗8 d。治疗后比较两组临床疗效;使用纯音乐听力检测仪测定两组患者治疗后500 Hz、1000 Hz下的听力阈值;比较两组患者的降钙素原(PCT)和超敏C反应蛋白(hs-CRP)水平及药物不良反应发生情况。结果治疗后,鼓室组总有效率为93.33%,高于静脉组的80.00%(χ^(2)=4.61,P<0.05);鼓室组患者500 Hz听力阈值为(38.69±3.56),显著低于静脉组的(42.36±4.36)(t=5.05,P<0.001);鼓室组患者1000 Hz听力阈值为(32.36±3.36),显著低于静脉组的(40.15±4.12)(t=11.35,P<0.001);鼓室组患者治疗后PCT为(0.65±0.12)μg/L,显著低于静脉组的(0.98±0.15)μg/L(t=13.30,P<0.001);鼓室组患者治疗后hs-CRP为(3.28±0.36)mg/L,显著低于静脉组的(5.26±0.56)mg/L(t=23.03,P<0.001);鼓室组不良反应发生率为8.33%,与静脉组的10.00%比较,差异无统计学意义(χ^(2)=0.10,P>0.05)。结论相对于静脉滴注PAI,鼓室内注射PAI可有效改善SHL患者的临床症状,提高临床疗效。

Objective To investigate the efficacy of intratympanic injection versus intravenous drip of prednisolone acetate in the treatment of sudden hearing loss.Methods A total of 120 patients with sudden hearing loss who received treatment in the Department of Otolaryngology,Mingzhou Hospital between January 2017 and January 2020 were included in this study.They were divided into intratympanic injection group(intratympanic injection of prednisolone acetate,n=60)and intravenous injection group(intravenous injection of prednisolone acetate,n=60)according to route of drug administration.After 8 days of treatment,clinical efficacy was compared between the two groups.The hearing thresholds at 500 Hz and 1000 Hz in both groups were detected using pure tone audiometry.The levels of procalcitonin and high-sensitivity C-reactive protein and adverse drug reactions were compared between the two groups.Results After treatment,total response rate in the intratympanic injection group was significantly higher than that in the intravenous injection group(93.33%vs.80.00%,χ^(2)=4.61,P<0.05).The hearing threshold at 500 Hz in the intratympanic injection group was significantly lower than that in the intravenous injection group[(38.69±3.56)vs.(42.36±4.36),t=5.05,P<0.001].The hearing threshold at 1000 Hz in the intratympanic injection group was significantly lower than that in the intravenous injection group[(32.36±3.36)vs.(40.15±4.12),t=11.35,P<0.001].After treatment,procalcitonin level in the intratympanic injection group was significantly lower than that in the intravenous injection group[(0.65±0.12)μg/L vs.(0.98±0.15)μg/L,t=13.30,P<0.001].High-sensitivity C-reactive protein level in the intratympanic injection group was significantly lower than that in the intravenous injection group[(3.28±0.36)mg/L vs.(5.26±0.56)mg/L,t=23.03,P<0.001].There was no significant difference in incidence of adverse reactions between intratympanic injection and intravenous injection groups(8.33%vs.10.00%,χ^(2)=0.10,P>0.05).Conclusion Compared with intravenous drip of prednisolone acetate,intratympanic injection of prednisolone acetate can improve the clinical symptoms of patients with sudden hearing loss and enhance clinical efficacy.