低等效剂量甲泼尼龙和高等效剂量地塞米松治疗全频下降型突发性聋效果比较

Comparison of Low Equivalent Dose of Methylprednisolone and High Equivalent Dose of Dexamethasone in the Treatment of All Frequency Descending Sudden Deafness

目的比较低等效剂量甲泼尼龙和高等效剂量地塞米松用于全频下降型突发性聋治疗中的临床效果。方法纳入2018年1月-2020年12月台州市第二人民医院和北大荒集团红兴隆医院收治的120例全频下降型突发性聋患者,按随机数字表法将其分为2组,每组60例。A组给予高等效剂量地塞米松,B组给予低等效剂量甲泼尼龙,比较两组总有效率、耳鸣致残评分、眩晕评分、纯音听阈值、生活质量评分、不良反应发生率、血糖指标。结果A组有效率86.67%,与B组90.00%相比,差异无统计学意义。两组耳鸣残疾度量表评分分别为28.12±8.70和27.69±8.65,眩晕残障量表评分分别为48.29±10.18和47.85±10.34,0.5、1.0、2.0 kHz频率纯音听阈值分别为A组20.84±3.56、19.37±3.84、18.06±3.41和B组20.52±3.47、19.08±3.79、17.72±3.56,均较治疗前降低(P<0.05),生活质量评分中生理、心理、环境、社会关系评分分别为A组83.67±6.42、84.01±6.37、82.16±6.43、83.29±6.60和B组84.05±6.59、84.39±6.28、82.47±6.38、83.62±6.71,均较治疗前增高(P<0.05)。治疗后,两组各项评分比较,差异无统计学意义。B组的不良反应发生率为1.67%,低于A组6.67%,但差异无统计学意义。两组治疗前后空腹血糖、餐后2 h血糖差异均无统计学意义。结论低等效剂量甲泼尼龙与高等效地塞米松在全频下降型突发性聋治疗中均具有显著疗效,可有效改善患者听力。

Objective To compare the clinical efficacy of a low equivalent dose of methylprednisolone and a high equivalent dose of dexamethasone in the treatment of all frequency descending sudden hearing loss.Methods A total of 120 patients with all frequency descending sudden hearing loss admitted to Taizhou Second People's Hospital and Beidahuang Group Hongxinglong Hospital between January 2018 and December 2020 were included and divided into two groups using the random number table method,with 60 cases in each.Group A was given a high equivalent dose of dexamethasone,while group B was given a low equivalent dose of methylprednisolone.The total effective rate,tinnitus disability score,vertigo score,pure tone hearing threshold,score of quality of life,incidence of adverse reactions,and levels of serum glucose were compared between the two groups.Results There was no significant difference in the effective rate between group A(86.67%)and group B(90.00%).The tinnitus handicap inventory scores of the two groups were 28.12±8.70 and 27.69±8.65,respectively.The dizziness handicap inventory scores were 48.29±10.18 and 47.85±10.34,respectively.The pure tone thresholds of 0.5,1.0 and 2.0 kHz were 20.84±3.56,19.37±3.84 and 18.06±3.41 in group A,and 20.52±3.47,19.08±3.79 and 17.72±3.56 in group B,which were all lower after treatment(P<0.05).The scores of physiology,psychology,environments and social connectedness in quality of life were 83.67±6.42,84.01±6.37,82.16±6.43 and 83.29±6.60 in group A,compared with 84.05±6.59,84.39±6.28,82.47±6.38 and 83.62±6.71 in group B,which were higher after treatment(P<0.05).After treatment,there was no significant difference in scores between the two groups.The incidence of adverse reactions in group B was 1.67%,which was lower than 6.67%in group A,but the difference was not statistically significant.There was no significant difference in fasting blood glucose and postprandial 2 h blood glucose between the two groups before and after treatment.Conclusion Both the low-equivalent dose of methylprednisolone and high-equivalent dose of dexamethasone have significant curative effects on the hearing of patients.