鼓室注射甲泼尼龙治疗糖尿病伴突发性耳聋的临床研究

Clinical study of intratympanic injection of methylprednisolone in the treatment of diabetes mellitus with sudden deafness

目的分析鼓室注射甲泼尼龙治疗糖尿病伴突发性耳聋的疗效。方法40例糖尿病伴突发性耳聋患者,随机分为观察组与对照组,各20例。对照组采用常规治疗,观察组在对照组的基础上联合鼓室注射甲泼尼龙治疗。比较两组治疗效果、治疗前后纯音听阈值(PTA)、生活质量评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、白细胞介素相关指标、炎症指标。结果观察组治疗总有效率为95.00%,高于对照组的70.00%,差异有统计学意义(P<0.05)。治疗后10、20 d,观察组PTA分别为(65.63±6.38)、(51.62±6.34)dB,均低于对照组的(76.64±7.41)、(58.75±5.52)dB,差异有统计学意义(P<0.05)。治疗后,观察组精力评分(77.31±5.51)分、社会功能评分(78.51±4.67)分、角色功能评分(76.56±5.34)分、躯体功能评分(77.61±3.51)分、心理健康评分(78.78±4.71)分、总体健康评分(78.41±4.41)分均高于对照组的(61.45±3.76)、(62.76±4.71)、(60.56±4.51)、(61.78±3.41)、(62.67±3.51)、(63.62±3.65)分,差异有统计学意义(P<0.05)。治疗后,观察组SDS评分(42.36±4.38)分、SAS评分(45.67±4.21)分均低于对照组的(48.56±3.65)、(55.33±5.46)分,差异有统计学意义(P<0.05)。治疗后,观察组白细胞介素(IL)-1(28.96±2.48)pg/ml、IL-6(26.37±2.17)pg/ml、IL-8(21.74±1.54)pg/ml、IL-10(22.33±2.25)pg/ml均低于对照组的(55.54±4.13)、(46.24±4.48)、(46.45±2.14)、(31.57±2.11)pg/ml,差异有统计学意义(P<0.05)。治疗后,观察组白细胞总数(WBC)(7.49±1.36)×10^(9)/L、降钙素原(PCT)(1.52±0.41)ng/L、C反应蛋白(CRP)(42.58±4.49)mg/L均低于对照组的(10.77±1.59)×10^(9)/L、(3.58±0.97)ng/L、(71.95±6.42)mg/L,差异有统计学意义(P<0.05)。结论鼓室注射甲泼尼龙可以改善糖尿病伴突发性耳聋患者的临床症状,提高其生活质量。

Objective To analyze the efficacy of intratympanic injection of methylprednisolone in the treatment of diabetes mellitus with sudden deafness.Methods A total of 40 patients with diabetes mellitus and sudden deafness were randomly divided into the observation group and the control group,with 20 cases in each group.The control group received conventional treatment,while the observation group received intratympanic injection of methylprednisolone on the basis of the control group.Both groups were compared in terms of therapeutic effect,pure tone average(PTA),quality of life score,self-rating depression scale(SDS)score,self-rating anxiety scale(SAS)score,interleukin-related indicators,and inflammatory indicators before and after treatment.Results The total effective rate of treatment in the observation group was 95.00%,which was higher than 70.00%in the control group,and the difference was statistically significant(P<0.05).At 10 and 20 d after treatment,the PTA of the observation group were(65.63±6.38)and(51.62±6.34)dB,which were lower than(76.64±7.41)and(58.75±5.52)dB of the control group,and the differences were statistically significant(P<0.05).After treatment,the energy score in the observation group was(77.31±5.51)points,the social function score was(78.51±4.67)points,the role function score was(76.56±5.34)points,the physical function score was(77.61±3.51)points,the mental health score was(78.78±4.71)points,and the overall healthy score was(78.41±4.41)points,which were higher than(61.45±3.76),(62.76±4.71),(60.56±4.51),(61.78±3.41),(62.67±3.51),and(63.62±3.65)points in the control group,and the differences were statistically significant(P<0.05).After treatment,the SDS score(42.36±4.38)points and SAS score(45.67±4.21)points of the observation group were lower than(48.56±3.65)and(55.33±5.46)points of the control group,and the differences were statistically significant(P<0.05).After treatment,the interleukin(IL)-1(28.96±2.48)pg/ml,IL-6(26.37±2.17)pg/ml,IL-8(21.74±1.54)pg/ml,IL-10(22.33±2.25)pg/ml of the observation group were lower than(55.54±4.13),(46.24±4.48),(46.45±2.14),and(31.57±2.11)pg/ml of the control group,and the differences were statistically significant(P<0.05).After treatment,the white blood cell count(WBC)of the observation group was(7.49±1.36)×10^(9)/L,the procalcitonin(PCT)was(1.52±0.41)ng/L,the C-reactive protein was(CRP)(42.58±4.49)mg/L,which were lower than(10.77±1.59)×10^(9)/L,(3.58±0.97)ng/L,(71.95±6.42)mg/L of the control group,and the differences were statistically significant(P<0.05).Conclusion Intratympanic injection of methylprednisolone can improve the clinical symptoms of patients with diabetes mellitus and sudden deafness and improve their quality of life.