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1.
目的:探讨神经节苷脂钠联合高压氧治疗突发性耳聋患者的疗效,并分析其对患者血清高迁移率蛋白-1(High mobility protein-1,HMGB1)、中性粒细胞激活肽-78(Neutrophil activating peptide-78,ENA-78)的影响。方法:选择我院2018年1月至2019年8月接诊的96例突发性耳聋患者,通过随机数表法将其分为观察组和对照组,每组48例。对照组在常规治疗基础上给予高压氧治疗,观察组在对照组的基础上给予神经节苷脂钠注射液治疗,两组均连续治疗2个疗程。治疗后,比较两组的临床疗效、治疗前后纯音听阈测试结果、凝血功能、血清HMGB1、ENA-78水平的变化及不良反应的发生情况。结果:治疗2个疗程后,观察组临床疗效总有效率明显高于对照组(93.75%vs79.17%),差异有统计学意义(P0.05);观察组纯音听阈测试结果明显低于对照组[(32.14±4.94)dB vs.(37.23±5.12)dB](P0.05),凝血酶原时间(Prothrombin time,PT)、部分活化凝血酶原时间(Partial activated prothrombin time,APTT)、凝血酶时间(Thrombin time,TT)明显短于对照组,纤维蛋白原(Fibrinogen,FIB)明显低于对照组。结论:神经节苷脂钠联合高压氧治疗突发性耳聋患者的效果显著优于单用高压氧治疗,其可有效促进听力恢复,且不增加药物不良反应,其机制可能与降低血清HMGB1、ENA-78水平有关。  相似文献   

2.
目的:探讨经皮腔内血管成形术(PTA)联合支架植入术治疗糖尿病下肢血管病变的临床效果及安全性。方法:选择2008年3月至2011年12月在我院内分泌科接受治疗的2型糖尿病合并糖尿病足的患者36例,将其随机分为观察组(19例)和对照组(17例)。观察组19例患者中,14例行PTA术,4例行PTA+腔内支架植入术,1例行截肢术;对照组17例患者,全部采用传统方法进行治疗。观察和比较两组患者术后的糖尿病下肢血管病变的特点、临床效果及并发症的发生情况。结果:观察组19例患者,共40条靶血管,实施PTA手术的成功率为87.5%。采用两种治疗方法 2周或4周后,患者的临床症状和体征均得到一定程度的缓解,且均未观察到明显的不良反应。与对照组相比,接受介入治疗的患者,其临床症状的缓解率明显升高,其中在2周时介入治疗对麻木和紫绀症状的缓解尤其显著,和对照组之间有统计学差异(P0.05)。结论:血管成形术介入治疗糖尿病下肢血管病变是一种安全可靠的方法,治疗效果好,安全性高,值得临床推广。  相似文献   

3.
高压氧逐渐被广泛的应用于多个医疗实践领域。作为一种特殊的治疗手段,临床医生会为他们的病人提供这种治疗选择,但对其机制却不十分了解。通过对高压氧作用机制详细阐述,为临床医生在医疗实践中提供科学依据。通过全面阐述高压氧的临床应用、并发症及禁忌症,更全面、系统的了解高压氧这种治疗手段,全面评估高压氧的治疗安全性。因高压氧具有增加氧输送、免疫功能和改变血液流变学的复合效应,而且安全性较高,用于治疗创伤、栓塞、感染等多种疾病。突发性耳聋是耳鼻咽喉科常见的急症,患者主要表现为突然发生的不同程度的感音神经聋,影响患者的生活。因目前突发性耳聋的病因尚不明确,治疗方案多种多样,如激素、抗凝药物、抗病毒药物等,但疗效均为得到肯定,无有效的统一治疗方案。通过分析评价多个随机对照试验,发现高压氧治疗可明显改善突发性耳聋(Sudden hearing loss,SHL)的听力下降,希望能为临床医生的治疗提供科学依据。可能存在其他的尚未发掘的治疗领域,期待临床上有更多的相关研究。  相似文献   

4.
目的:研究高压氧联合地塞米松治疗突发性耳聋的疗效及对血液流变学的影响。方法:选择2012年6月至2015年1月在我院接受治疗的突发性耳聋患者90例(124耳)进行研究。根据数字法随机分成观察组(45例,60耳)及对照组(45例,64耳),两组均给予常规的改善内耳微循环及神经营养类制剂治疗,对照组另给予地塞米松治疗,观察组在对照组基础上另给予高压氧治疗,治疗1个疗程后对比两组疗效,听力改善程度以及血液流变学指标变化。结果:观察组的总有效率是98.33%,显著高于对照组的89.06%,差异有统计学意义(P0.05)。治疗后观察组的听力损失程度显著优于对照组,纯音听阈显著低于对照组,差异有统计学意义(P0.05)。治疗后观察组的高切粘度、中切粘度、低切粘度、红细胞聚集指数均分别显著低于对照组,红细胞变形指数显著高于对照组,差异均有统计学意义(均P0.05)。结论:高压氧联合地塞米松治疗突发性耳聋患者具有更为显著的疗效,且可有效改善患者的血液流变学指标,值得临床推荐。  相似文献   

5.
目的:探究甲基强的松龙联合中剂量环磷酰胺(CTX)治疗重症肌无力危象(MGC)的临床效果及安全性。方法:选取2012年1月~2015年6月在我院神经内科就诊的MGC患者90例,随机分为对照组(45例)和观察组(45例),对照组患者接受甲基强的松龙治疗,观察组采用甲基强的松龙联合中剂量CTX治疗。比较两组患者的临床疗效及不良反应的发生情况。结果:观察组患者呼吸困难消失时间、吞咽功能恢复时间和肢体无力症状改善时间均明显短于对照组(P0.05);观察组用药7 d内治疗有效率86.7%明显高于对照组(P0.05),肺部感染发生率20%,较对照组显著降低,差异均具有统计学意义(P0.05)。结论:甲基强的松龙联合中剂量CTX可有效提高MGC的治疗效果,促进患者早日康复,且肺部感染的发生率降低。  相似文献   

6.
目的:探讨使用西格列汀对老年2型糖尿病合并轻中度慢性心衰患者外周血超敏C反应蛋白(high-sensitivity C-reactive Protein,hs-CRP)、N-端B型脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)的影响。方法:将我院90例老年2型糖尿病合并轻中度慢性心衰患者随机分成观察组和对照组分别46例和44例。两组患者均给予常规抗心衰治疗,对照组予以格列吡嗪控释片降糖,观察组予以西格列汀口服降糖治疗。检测试验前后患者血清hs-CRP及NT-proBNP的水平,并常规检测血压、血脂、糖化血红蛋白、血糖及肝肾功能等指标。结果:两组治疗后HbA1c水平与治疗前比较均有下降,差异均有统计学意义(P0.05);西格列汀组的hs-CRP、NT-proBNP水平治疗后分别下降至6.67±0.85 mg/L,1412.27±92.28 pg/m L,与治疗前比较差异均有统计学意义(P0.05);治疗后西格列汀组的hs-CRP、NT-proBNP水平与对照组比较差异有统计学意义(P0.05)。结论:2型糖尿病合并轻中度慢性心功能不全患者服用西格列汀除有效降糖外还能一定程度地降低hs-CRP和NT-proBNP水平,提示其潜在改善心脏功能的作用。  相似文献   

7.
目的:探讨甲基强的松龙对急性脊髓损伤患者神经生长因子水平变化及临床疗效的影响。方法:回顾性研究我院收治的68例急性脊髓损伤患者的临床资料,随机分为实验组和对照组,每组34例。对照组患者给予常规治疗,实验组患者在对照组基础上给予甲基强的松龙治疗。观察并比较治疗前后两组患者神经生长因子(NGF)、脑源性神经营养因子(BDNF)水平变化及神经功能评分和并发症的发生情况。结果:与治疗前相比,两组患者治疗后血清NGF及BDNF水平均升高,且感觉功能评分及运动功能评分均升高,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后血清NGF及BDNF水平较高,感觉功能评分及运动功能评分较高,差异具有统计学意义(P0.05);与对照组相比,实验组患者并发症的发生率较低,差异具有统计学意义(P0.05)。结论:甲基强的松龙治疗急性脊髓损伤的临床疗效较好,能够提高患者血清NGF及BDNF水平,改善感觉功能评分及运动功能评分,同时降低并发症的发病率。  相似文献   

8.
杨智玲  吴应玲  莫海兰  谭健  李兵 《生物磁学》2014,(25):4994-4996
高压氧逐渐被广泛的应用于多个医疗实践领域。作为一种特殊的治疗手段,临床医生会为他们的病人提供这种治疗选择,但对其机制却不十分了解。通过对高压氧作用机制详细阐述,为临床医生在医疗实践中提供科学依据。通过全面阐述高压氧的临床应用、并发症及禁忌症,更全面、系统的了解高压氧这种治疗手段,全面评估高压氧的治疗安全性。因高压氧具有增加氧输送、免疫功能和改变血液流变学的复合效应,而且安全性较高,用于治疗创伤、栓塞、感染等多种疾病。突发性耳聋是耳鼻咽喉科常见的急症,患者主要表现为突然发生的不同程度的感音神经聋,影响患者的生活。因目前突发性耳聋的病因尚不明确,治疗方案多种多样,如激素、抗凝药物、抗病毒药物等,但疗效均为得到肯定,无有效的统一治疗方案。通过分析评价多个随机对照试验,发现高压氧治疗可明显改善突发性耳聋(Sudden hearing loss,SHL)的听力下降,希望能为临床医生的治疗提供科学依据。可能存在其他的尚未发掘的治疗领域,期待临床上有更多的相关研究。  相似文献   

9.
目的:探讨强化降糖治疗对2型糖尿病(T2DM)患者生存质量及血糖的影响.方法:将120例T2DM患者随机分为观察组和对照组.对照组按照<中国糖尿病防治指南>给予标准降糖治疗,治疗组给予强化降糖治疗.两组患者在治疗前和随访3年后分别进行生存质量评价和血糖指标测查.结果:治疗后,治疗组生存质量各维度评分及总分与治疗前和对照组比较显著下降(P<0.05),对照组治疗前后生存质量各维度评分及总分差异无统计学意义(P>0.05);两组治疗后血糖水平均明显降低,与治疗前比较有显著性差异(P<0.05),且治疗组与对照组比较显著降低(P<0.05).结论:采用强化降糖治疗,可以达到血糖的理想控制,提高患者的生存质量.  相似文献   

10.
目的:本研究旨在探究2型糖尿病合并急性脑梗死的临床疗效。方法:对我市医院门诊及住院部在2014年1月至2015年9月间收录的358例2型糖尿病合并急性脑梗塞患者的治疗情况进行,依照患者治疗方法的差异,将本组患者分成两组,分别是对照组和观察组,对照组实施常规糖尿病及脑梗塞治疗,观察组在其基础上加用依达拉奉联合银杏达莫治疗,持续治疗3周后,评估治疗效果。结果:治疗三周后,两组患者的椎基底动脉血流速度均有明显改善(P0.05),观察组的改善程度较对照组更为显著(P0.05);观察组患者的神经功能缺损评分为(10.96±2.4)分,对照组为(16.21±3.1)分,则观察组患者神经功能显著由于对照组(P0.05);观察组患者临床治疗有效率为95.35%,对照组为72.03%,则观察组治疗有效率显著高于对照组,且具有统计学意义(P0.05);对照组的平均住院时间为(4.2±1.3)周,观察组的平均住院时间为(2.8±0.9)周。结论:对于2型糖尿病合并急性脑梗塞患者,在临床综合治疗的基础上加用依达拉奉联合银杏达莫治疗效果显著,能够显著提升患者椎基底动脉的血流速度,改善神经功能缺损,提高临床治疗效果,具有较大推广应用优势及价值。  相似文献   

11.
We aimed to compare the treatment outcomes and the occurrence rates of adverse events associated with different steroid regimens in geriatric patients (aged 65 years or older) with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). After thorough medical chart reviews of 109 patients with ISSNHL between May 2006 and December 2013, we performed a propensity score-matched analysis using previously known prognostic factors, steroid regimens, and other cointerventions. Patients were divided based on their steroid regimens into group I (which initially received 48 mg of methylprednisolone daily with a subsequently tapered dose) and group II (which initially received 24 mg of methylprednisolone daily with a subsequently tapered dose). We compared final hearing and the occurrence of adverse events between the two groups. As a result, 20 pairs of propensity score-matched patients (n = 40) were enrolled. Group I patients showed better final hearing levels compared with group II patients (42.00±22.35 dB and 57.38±26.40 dB, respectively), although this difference was marginally significant (p = 0.058). Based on the comparative analysis of each of the frequencies in the final audiograms, lower hearing thresholds at 2 KHz were observed in group I (p = 0.049). There was no significant difference in the occurrence of adverse effects between the two groups (p>0.05). In conclusion, conventional steroid regimens produced adverse event occurrence rates that were similar to those of low-dose treatment but may also have produced superior hearing recovery. The use of steroid dose reduction in geriatric patients with ISSNHL is not preferable to conventional steroid regimens.  相似文献   

12.
目的:探讨丹参酮IIA 磺酸钠注射液辅助治疗对突发性耳聋患者血液流变学及临床疗效的影响。方法:选取我院收治的突发 性耳聋患者78 例,并将其随机分为实验组和对照组,每组39 例。对照组给予三磷酸腺苷二钠、辅酶A、复合维生素、双密达莫片 及高压氧治疗,而实验组在对照组的基础上给予丹参酮IIA 磺酸钠注射液治复合组治疗。观察和比较两组患者治疗后的听力恢复 等级分布以及治疗前后的电测听情况和各项血液流变学指标的变化情况。结果:治疗后,与对照组比较,实验组听力恢复Ⅰ级患 者的比例更高,电听力平均值均显著降低,各项血液流变学指标均明显改善,差异均有统计学意义(P<0.05)。结论:丹参酮IIA 磺酸 钠注射液辅助治疗能够显著提高突发性耳聋的临床疗效,这可能其改善患者的血液流变学有关  相似文献   

13.

Background

Approximately 2–4% of newborns with perinatal risk factors present with hearing loss. Our aim was to analyze the effect of hearing aid use on auditory function evaluated based on otoacoustic emissions (OAEs), auditory brain responses (ABRs) and auditory steady state responses (ASSRs) in infants with perinatal brain injury and profound hearing loss.

Methodology/Principal Findings

A prospective, longitudinal study of auditory function in infants with profound hearing loss. Right side hearing before and after hearing aid use was compared with left side hearing (not stimulated and used as control). All infants were subjected to OAE, ABR and ASSR evaluations before and after hearing aid use. The average ABR threshold decreased from 90.0 to 80.0 dB (p = 0.003) after six months of hearing aid use. In the left ear, which was used as a control, the ABR threshold decreased from 94.6 to 87.6 dB, which was not significant (p>0.05). In addition, the ASSR threshold in the 4000-Hz frequency decreased from 89 dB to 72 dB (p = 0.013) after six months of right ear hearing aid use; the other frequencies in the right ear and all frequencies in the left ear did not show significant differences in any of the measured parameters (p>0.05). OAEs were absent in the baseline test and showed no changes after hearing aid use in the right ear (p>0.05).

Conclusions/Significance

This study provides evidence that early hearing aid use decreases the hearing threshold in ABR and ASSR assessments with no functional modifications in the auditory receptor, as evaluated by OAEs.  相似文献   

14.
Progressive sensorineural hearing loss is the most common form of acquired hearing impairment in the human population. It is also highly prevalent in inbred strains of mice, providing an experimental avenue to systematically map genetic risk factors and to dissect the molecular pathways that orchestrate hearing in peripheral sensory hair cells. Therefore, we ascertained hearing function in the inbred long sleep (ILS) and inbred short sleep (ISS) strains. Using auditory-evoked brain stem response (ABR) and distortion product otoacoustic emission (DPOAE) measurements, we found that ISS mice developed a high-frequency hearing loss at twelve weeks of age that progressed to lower frequencies by 26 weeks of age in the presence of normal endocochlear potentials and unremarkable inner ear histology. ILS mice exhibited milder hearing loss, showing elevated thresholds and reduced DPOAEs at the higher frequencies by 26 weeks of age. To map the genetic variants that underlie this hearing loss we computed ABR thresholds of 63 recombinant inbred stains derived from the ISS and ILS founder strains. A single locus was linked to markers associated with ISS alleles on chromosome 10 with a highly significant logarithm of odds (LOD) score of 15.8. The 2-LOD confidence interval spans ∼4 Megabases located at position 54–60 Mb. This locus, termed sensorineural hearing loss 1 (Snhl1), accounts for approximately 82% of the phenotypic variation. In summary, this study identifies a novel hearing loss locus on chromosome 10 and attests to the prevalence and genetic heterogeneity of progressive hearing loss in common mouse strains.  相似文献   

15.
Sildenafil citrate (Viagra), a phosphodiesterase 5 inhibitor (PDE5i), is a commonly prescribed drug for erectile dysfunction. Since the introduction of Viagra in 1997, several case reports have linked Viagra to sudden sensorineural hearing loss. However, these studies are not well controlled for confounding factors, such as age and noise-induced hearing loss and none of these reports are based on prospective double-blind studies. Further, animal studies report contradictory data. For example, one study (2008) reported hearing loss in rats after long-term and high-dose exposure to sildenafil citrate. The other study (2012) showed vardenafil, another formulation of PDE5i, to be protective against noise-induced hearing loss in mice and rats. Whether or not clinically relevant doses of sildenafil citrate cause hearing loss in normal subjects (animals or humans) is controversial. One possibility is that PDE5i exacerbates age-related susceptibility to hearing loss in adults. Therefore, we tested sildenafil citrate in C57BL/6J, a strain of mice that displays increased susceptibility to age-related hearing loss, and compared the results to those obtained from the FVB/N, a strain of mice with no predisposition to hearing loss. Six-week-old mice were injected with the maximum tolerated dose of sildenafil citrate (10 mg/kg/day) or saline for 30 days. Auditory brainstem responses (ABRs) were recorded pre- and post injection time points to assess hearing loss. Entry of sildenafil citrate in the mouse cochlea was confirmed by qRT-PCR analysis of a downstream target of the cGMP-PKG cascade. ABR data indicated no statistically significant difference in hearing between treated and untreated mice in both backgrounds. Results show that the maximum tolerated dose of sildenafil citrate administered daily for 4 weeks does not affect hearing in the mouse. Our study gives no indication that Viagra will negatively impact hearing and it emphasizes the need to revisit the issue of Viagra related ototoxicity in humans.  相似文献   

16.

Objective

The role of preexisting sensorineural hearing impairment on the risk for sudden sensorineural hearing loss (SSHL) is still unclear. In this study, we aimed to assess the risk of SSHL in patients with common preexisting sensorineural hearing impairment using population-based data.

Methods

A population-based case-control study design was used to analyze claims data between January 2001 and December 2011 obtained from the Taiwan National Health Insurance Research Database. The cases consisted of 514 patients with SSHL and the controls were frequency matched to 2,570 cases by sex, 10-year age group, and year of index date. Common sensorineural hearing impairments were retrospectively assessed in the cases and controls. Associations between sensorineural hearing impairment and risk of SSHL were evaluated using unconditional univariate and multivariate logistic regression analyses.

Results

The mean age for the 3,084 study subjects was 53.1 years (standard deviation, S.D. = 15.6). Of the 514 cases, 49 (9.5%) had sensorineural hearing impairment while only 44 (1.7%) of the 2,570 controls had the same condition. Univariate logistic regression analyses indicated that preexisting sensorineural hearing impairment was significantly associated with SSHL (odds ratio, OR = 6.05, p < 0.001). Other comorbidities including hypertension, diabetes mellitus, and hyperlipidemia also showed significant associations with SSHL. Similar results were obtained when the association between SSHL and sensorineural hearing impairment was adjusted with either all the covariates (adjusted OR = 6.22, p < 0.001) or with only those selected using a backward elimination procedure (adjusted OR = 6.20, p < 0.001).

Conclusions

Results from this population-based case-control study revealed that common sensorineural hearing impairment might be a novel risk factor for SSHL.  相似文献   

17.
In order to give a contribution to the genesis of the EOAEs, we have recorded echos in 24 subjects with unilateral sudden deafness (I. group); 20 ears with Menière disease (II. group); 22 ears with progressive sensorineural hearing loss (III. group) and 10 normally hearing young subjects as control group. The results have shown that the EOAEs were present in 100% (I. group), 84.6% (II. group) and 86.3% (III. group) in response to the tone-burst; while the echos were present only in the 57.1% (I. group), 38.4% (II. group) and 45.4% (III. group) in response to the click, although the audiometric threshold mean were greater than 45 dB HL for 2-4 KHz and 1 KHz in the three experimental groups except for 2-4 KHz in the subjects with Menière disease (37.5 dB HL). The properties of EOAEs (detection and saturation threshold, dynamic range and duration) depended on the degree of hearing loss. Our results seem to corroborate the hypothesis that EOAEs could be also produced by a passive intracochlear mechanism attributable to the travelling wave of the basilar membrane provoked by the perilymph. In the normal ear this passive mechanism could be superimposed by an active mechanism, linked to the contractile activity of the outer hair cells with a consequent increase in amplitude of the EOAEs for the same stimulus intensity.  相似文献   

18.
目的:观察光子中医信息疗法对糖尿病周围神经病变患者的临床疗效。方法:将60例符合入选标准的患者,以1∶1的比例随机分配到治疗组(光子中医信息疗法联合药物组)、对照组(药物组),两组患者均给予糖尿病基础治疗,对照组加甲钴胺口服,每次500μg,每日3次,疗程4周;治疗组在对照组的基础上配合光子中医信息疗法,隔日照射1次,每周3次,6次为1疗程,共2个疗程。治疗前后分别对两组患者的中医临床症状、神经症状体征进行评定,并测定周围神经传导速度及观察血糖变化情况,进行综合疗效评估。结果:治疗组的临床综合疗效明显优于对照组,两组的总有效率比较有显著性差异(P<0.05)。治疗组在中医症状改善、周围神经症状及体征改善、提高周围神经传导速度方面均优于对照组,组间比较均具有显著性差异(P<0.05)。治疗后治疗组空腹血糖、餐后血糖、糖化血红蛋白与治疗前比较均明显降低(P<0.01),对照组治疗前后比较及治疗后组间比较均无显著性差异(P>0.05)。结论:光子中医信息疗法联合药物组相对于药物组在改善DPN患者的临床症状、周围神经症状及体征、神经的传导速度等方面均有良好的优势,同时具有一定的辅助降糖趋势。  相似文献   

19.
A certain degree of noise can cause hearing problems without a permanent change in the hearing threshold, which is called hidden hearing loss and results from partial loss of auditory synapses. Photobiomodulation (PBM) enhances neural growth and connections in the peripheral nervous systems. In this study, we assessed whether PBM could rescue cochlear synaptopathy after acoustic overexposure in rat. PBM was performed for 7 days after noise exposure. The auditory brainstem responses (ABRs) were acquired before and after noise exposure using a tone and a paired‐click stimulus. Auditory response to paired click sound with short time interval was performed to evaluate auditory temporal processing ability. In the result, hearing threshold recovered 2 weeks after noise exposure in both groups. Peak wave 1 amplitude of the ABR and ABR recovery threshold did not recover in the noise only group, whereas it fully recovered in the noise + PBM group. The number of synaptic ribbons was significantly different in the control and noise only groups, while there was no difference between the control and noise + PBM group. These results indicate that PBM rescued peak wave 1 amplitude and maintained the auditory temporal processing ability resulting from a loss of synaptic ribbons after acoustic overexposure.  相似文献   

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