耳后乳突骨膜下注射甲泼尼龙琥珀酸钠与地塞米松磷酸钠治疗突发性聋患者的效果比较

Comparison of effects of mastoid subperiosteal injection of Methylprednisolone sodium succinate and Dexamethasone sodium phosphate in treatment of patients with sudden sensorineural hearing loss

目的:比较耳后乳突骨膜下注射甲泼尼龙琥珀酸钠(MPS)与地塞米松磷酸钠治疗突发性聋(SSNHL)患者的效果。方法:回顾性分析2020年1月至2021年1月该院收治的104例SSNHL患者的临床资料,按照治疗方法不同将其分为对照组和观察组各52例。两组均行常规治疗,在此基础上,对照组于耳后乳突骨膜下注射地塞米松磷酸钠治疗,观察组于耳后乳突骨膜下注射MPS治疗,两组均连续治疗10 d。比较两组治疗前后纯音听阈值、临床疗效、血清学指标[可溶性血管细胞黏附分子-1(sVCAM-1)、细胞间黏附分子-1(ICAM-1)、血管内皮生长因子(VEGF)]水平及不良反应发生率。结果:治疗后,观察组纯音听阈值低于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为92.31%(48/52),高于对照组的76.92%(40/52),差异有统计学意义(P<0.05);观察组sVCAM-1、ICAM-1水平均低于对照组,VEGF水平高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:耳后乳突骨膜下注射MPS治疗SSNHL患者可提高治疗总有效率,改善血清学指标水平,降低纯音听阈值,效果优于耳后乳突骨膜下注射地塞米松磷酸钠治疗。

Objective: To compare effects of mastoid subperiosteal injection of Methylprednisolone sodium succinate(MPS) and Dexamethasone sodium phosphate in treatment of sudden sensorineural hearing loss(SSNHL). Methods: The clinical data of 104 patients with SSNHL admitted to this hospital from January 2020 to January 2021 were retrospectively analyzed. According to different treatment methods, they were divided into control group and observation group, 52 cases in each. Both groups were treated with routine treatment. On this basis, the control group was treated with mastoid subperiosteal injection of Dexamethasone sodium phosphate, while the observation group was treated with mastoid subperiosteal injection of MPS. Both groups were treated for 10 d. The pure tone hearing threshold, the clinical efficacy, the serological index levels [soluble vascular cell adhesion molecule-1(sVCAM-1), intercellular adhesion molecule-1(ICAM-1), vascular endothelial growth factor(VEGF)],and the incidence of adverse reactions were compared between the two groups before and after the treatment. Results: After the treatment, the pure tone hearing threshold of the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). The total effective rate of treatment in the observation group was 92.31%(48/52), which was higher than 76.92%(40/52) in the control group, and the difference was statistically significant(P<0.05). The levels of sVCAM-1 and ICAM-1 in the observation group were lower than those in the control group, the level of VEGF was higher than that in the control group, and the differences were statistically significant(P<0.05). However, there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions: Mastoid subperiosteal injection of MPS in the treatment of the SSNHL patients can improve the total effective rate of treatment, improve the levels of serological indexes, and reduce the pure tone hearing threshold. Moreover, it is superior to mastoid subperiosteal injection of Dexamethasone sodium phosphate.