地塞米松中耳给药治疗爆震性听力损失的实验研究  

Therapeutic efficacy of middle ear administration of dexamethasone on impulsive noise-induced hearing loss:an experimental study

作　　者：杨美琴[1] 迟放鲁[1] 高文元[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2008年第1期15-17,I0002,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金面上项目(30570444)

摘　　要：目的探讨地塞米松(dexamethasone,DEX)治疗豚鼠爆震性听力损失的给药途径。方法将24只成年豚鼠经脉冲噪声(167dBSPL,间隔2s,80发)暴露后,随机分为3组,每组8只。A组常规耳后切口,将浸透DEX的明胶海绵颗粒置于圆窗龛上。B组在手术显微镜下找到鼓膜,穿刺后将浸透DEX的明胶海绵颗粒置于圆窗龛上。C组手术方法同A组,给予生理盐水。分别于爆震前,爆震后24h及治疗后3周检测豚鼠听性脑干反应(auditory brainstem response,ABR)。琥珀酸脱氢酶染色(succinic dehydrogenase,SDH)基底膜铺片,观察毛细胞。结果ABR检测结果显示:治疗后3周A组和C组ABR click反应阈移差异有统计学意义(P=0.003);A组和B组,B组和C组比较差异均无统计学意义。SDH基底膜铺片观察3组毛细胞,见A组和B组毛细胞恢复均较C组好,但是A组恢复更佳。结论耳后径路和鼓膜直接穿刺给予DEX对豚鼠爆震性听力损失均有作用,前者效果明显。Objective To investigate the administration route of dexamethasone （DEX） in treating guinea pigs with impulsive noise-induced deafness. Methods Twenty-four guinea pigs with impulsive noise-induced deafness （ peak value： 167 dB SPL; duration： 2 s ;80 shots） were randomly divided into three groups with 8 in each group. Guinea pigs in group A and C underwent a post-auricular approach surgery. In group B, guinea pigs were treated transtympanically. After finding the round window niche, a small piece of gelatin sponge infiltrated with DEX （in group A and B） or sodium chloride（ in group C） was put on it. Auditory brainstem response （ABR） was detected before and 24 hours after the noise exposure and 3 weeks after the treatment respectively. All cochleas were dyed with succinic dehydrogenase and stretched preparation for observation. Results Three weeks after the administration, the difference in the ABR click threshold shift between group A and C was significant（P =0.003）, but not between group A and B, B and C. The recovery of the injured hair cells in group A and B was better than that in group C. Conclusions DEX has a therapeutic effect on the impulsive noise-induced hearing loss both by transtympanic and post-auricular approach, with the former more effective. （ Chin J Ophthalmol and Otorhinolaryngol,2008,8 ： 15-17 ）

关 键 词：圆窗膜 耳后径路 鼓膜 

分 类 号：R764[医药卫生—耳鼻咽喉科]