铂类药物对实体瘤患儿听力损伤研究  

Study on hearing loss in children with solid tumors treated with platinum based drugs

作　　者：崔丽雅 黄东生[1] 张谊[1] 王一卓[1] 胡慧敏[1] 张伟令[1] CUI Liya;HUANG Dongsheng;ZHANG Yi;WANG Yizhuo;HU Huimin;ZHANG Weiling(Department of Pediatrics,Beijing Tongren Hospital,Capital Medical University,Beijing,100176 China)

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100176

出　　处：《中国小儿血液与肿瘤杂志》2024年第5期344-348,共5页Journal of China Pediatric Blood and Cancer

基　　金：首发卫生发展专项自主创新(首发2022-2-2055,首发2024-2-2056)。

摘　　要：目的 观察不同铂类化疗药物对实体瘤患儿的听力损伤情况。方法 采用回顾性分析方法,收集2022年1月—2023年12月于北京同仁医院化疗的实体瘤患儿相关资料,监测不同化疗周期时纯音测听、听性脑干反应阈值、畸变产物耳声发射、声导抗、耳蜗微电位、稳态听觉诱发电位结果,并计算出现听力损伤时的铂类药物累积剂量。结果 纳入26例患儿,中位年龄2.6(0.5-13.2)岁。26例患儿中共有6例(23.1%)出现听力损伤。患儿在应用大剂量卡铂及顺铂时出现不同听力图表现异常,顺铂平均累积量417mg/m^(2),卡铂平均累积量3360mg/m^(2),奈达铂平均累积量240mg/m^(2)。结论 大剂量铂类药物可引起实体瘤患儿化疗过程中听力损伤,儿童化疗期间建议常规采用多种测听方法进行听力检测并进行联合评估,并长期随访。Objective To observe the side effects on hearing loss in children with solid tumors who treated by platinum chemotherapy drugs.Methods Clinical data of children with solid tumor who underwent chemotherapy at Beijing Tongren Hospital from January 2022 to December 2023 were collected.After excluding relevant factors,26 children(52 ears) were selected and monitored for related audiological results at different chemotherapy cycles.Pure tone audiometry,auditory brainstem response,distortion-product otoacoustic emission,acoustic immittance,cochlear microphonics and multiple auditory steady-state evoked responses were examined.The relevant audiological results and hearting damages were monitored during different chemotherapy cycles.Results The patients′ age ranges from 0.5 to 13.2 years,with a median age of 2.6 years.The children with hearing loss when using high-dose carboplatin and cisplatin,and younger children were more prone to high-frequency hearing loss.Conclusions High-dose platinum drugs can cause hearing loss during chemotherapy in children with solid tumors.Children′s audiometry should be evaluated in combination with multiple methods,and long-term follow-up is required.

关 键 词：铂类药物 儿童实体瘤 听力损伤 

分 类 号：R730.5[医药卫生—肿瘤] R764.43[医药卫生—临床医学]