聚维酮碘对豚鼠耳毒性的实验观察  

Ototoxicity of Povidone-Iodine in Guinea Pigs

作　　者：廖辉煌 金雪玲[1] 夏云燕 李朝霞[1] 陈静[1] 熊园平[1] 余蓉 涂翔 罗五根[1] LIAO Huihuang;JIN Xueling;XIA Yunyan;LI Zhaoxia;CHEN Jing;XIONG Yuanping;YU Rong;TU Xiang;LUO Wugen(Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Nanchang University,Nanchang 330000;Department of Otorhinolaryngology Head and Neck Surgery,the Seventh Affiliated Hospital of Sun Yat-Sen University,Shenzhen 518107)

机构地区：[1]南昌大学第一附属医院耳鼻咽喉头颈外科,南昌330000 [2]中山大学附属第七医院耳鼻咽喉头颈外科,深圳518107

出　　处：《中华耳科学杂志》2022年第6期929-936,共8页Chinese Journal of Otology

基　　金：江西省教育厅一般项目资助,项目编号:GJJ160130。

摘　　要：目的探讨5%聚维酮碘溶液对豚鼠中耳黏膜损伤程度及内耳毒性。方法选取26只体重及听力正常的豚鼠,随机分成4组,一次生理盐水给药组(Once saline,OS)4只,双耳经鼓室注射一次生理盐水0.2ml;一次聚维酮碘给药组(Once PVP-I,OP)9只,双耳经鼓室注射一次5%聚维酮碘0.2ml;连续生理盐水给药组(Continuous saline,CS)4只,双耳经鼓室注射生理盐水0.2ml;每日一次,连续7天;连续聚维酮碘给药组Continuous PVP-I,CP)9只,双耳经鼓室注射5%聚维酮碘0.2ml;每日一次,连续7天;全部给药结束后行ABR检测;检测后快速取出听泡,通过评分系统对中耳腔进行评分;将中耳和内耳渗出物进行HE染色;随后剥离耳蜗基底膜,经免疫荧光染色观察毛细胞数目。结果实验前,所有组豚鼠听力全部正常。实验后,OS组和CS组各有1耳听力稍有下降,但不超过10dB nHL,差异无统计学意义(P>0.05),OS组中耳黏膜未出现黏膜增厚、血肿、充血、粘连;CS组偶见黏膜增厚和充血,OS组和CS组免疫荧光染色中未见毛细胞丢失,毛细胞形态正常。OP组中有2耳听力无下降,其余16耳有10-65dB nHL听力下降,差异有统计学意义(P<0.05),中耳以黏膜充血和血肿为主要变化,无黏膜增厚和粘连现象,免疫荧光染色结果未见毛细胞丢失,细胞形态正常。CP组有14耳全聋,90dB nHL未能引出III波,其余4耳亦有听力损失,差异有统计学意义(P<0.05),全部中耳均有明显粘连、黏膜增厚、充血和血肿,各回毛细胞均有不同程度丢失。进一步分析发现CP组听力下降最明显,OP组次之,OS和CS组听力改变最不明显。结论5%聚维酮碘溶液可对中耳黏膜产生损伤并具有耳毒性。Objective To report ototoxicity of 5%Povidone-Iodine solution in guinea pigs including damage to middle ear mucosa.Methods A total of 26 guinea pigs of normal weight with normal hearing randomly assigned to receive one dose of normal saline(0.2 ml,transtympanic)(OS,n=4),one dose of 5%povidone-iodine via(0.2 ml transtympanic)(OP,n=9),daily bilateral transtympanic injection of 0.2 ml of normal saline for 7 consecutive days(CS,n=4),or daily bilateral transtympanic injection of 0.2 ml of 5%povidone-iodine for 7 consecutive days(CP,n=9).ABR test was completed at the end of treatment,and the auditory bulla harvested immediately.Condition of the middle ear cavity was rated and middle and inner ear exudates stained with HE.The cochlea basilar membrane was then collected and the hair cells counted after immunofluorescence staining.Results Prior to treatment,all guinea pigs exhibited normal ABRs.Upon completion of treatment,animals in the OS and CS groups showed only slight ABR threshold elevations of no more than 10 dB nH(P>0.05),with no middle ear mucosal thickening,hematoma,hyperemia of adhesions in the OS group and mucosal thickening and hyperemia in only a few animals in the CS group.Hair cell morphology was normal with no hair cell loss in OS and CS groups.Albeit 2 ears in the OP group showed no hearing loss,the remaining 16 ears showed ABR threshold elevations of 10-65 dB nHL(P<0.05).The main changes in the middle ear in this group were mucosal thickening and hematoma,without adhesion phenomenon.Iimmunofluorescence staining showed no loss of hair cells and normal hair cell morphology.Loss of ABRs(no wave III at 90 dB nHL)was seen in 14 ears in the CP group and various levels of ABR threshold elevations in the remaining 4 ears(P<0.05).Significant adhesion,thickened mucosa,hyperemia and hematoma were seen in the middle ear,with hair cells loss in all turns of varying degrees.ABR changes were most severe in the CP group,followed by the OP,OS and CS groups.Conclusion 5%povidone-iodine solution can damage the middle ear

关 键 词：聚维酮碘 豚鼠 毛细胞 耳毒性 听性脑干反应 

分 类 号：R764[医药卫生—耳鼻咽喉科]