巴曲酶个性化用药治疗全频下降型突聋

doi:10.6040/j.issn.1673-3770.0.2024.097

摘要/Abstract

摘要： 目的研究不同剂量巴曲酶治疗全频下降型突聋的疗效。方法将同意接受巴曲酶治疗的全频下降型突发性耳聋患者根据治疗前血浆纤维蛋白原(fibrinogen, Fib)水平分为A组(23例):1 g/L≤Fib<2 g/L;B组(41例):2 g/L≤Fib≤4 g/L;C组(22例):Fib>4 g/L;不同意接受巴曲酶治疗患者设为D组(34例)。常规药物治疗基础上,A、B、C组首次分别给予巴曲酶5 Bu、10 Bu、15 Bu,用药后隔1~2 d复查Fib,如Fib<1 g/L,暂缓使用;如1 g/L≤Fib(复查)<2 g/L,予巴曲酶5 Bu,如2g/L≤Fib(复查)≤4 g/L,予巴曲酶10 Bu,如Fib(复查)>4 g/L,予巴曲酶15 Bu。整个疗程一共给予3次巴曲酶治疗,总剂量15 Bu~45 Bu。比较治疗后各组患者总有效率差异情况。结果 4组患者治疗后平均听阈均得到提高,组内治疗前、后平均听阈相比较有统计学意义(P<0.05);A~D组总有效率分别为56.52%、46.34%、63.64%、20.59%,差异有统计学意义(P<0.05),A组和D组、B组和D组、C组和D组总有效率差异有统计学意义(P<0.05),而A组、B组、C组两两之间总有效率差异无统计学意义(P>0.05);4组患者疗效分级比较无统计学意义(P>0.05)。结论 4组治疗方法均有效,A组、B组、C组疗效优于D组,认为在治疗全频下降型突发性耳聋方案中,加入巴曲酶后疗效更佳,而巴曲酶的首次使用剂量以及维持剂量的不同并不影响最终疗效。

关键词: 全频下降型突发性耳聋, 巴曲酶, 血纤维蛋白原, 病例对照研究

Abstract: Objective To study the therapeutic effect of different doses of batroxobin in the treatment of sudden deafness with full frequency hearing loss. Methods Individuals who consented to receive Batroxobin treatment for sudden full frequency descending deafness were categorized into three groups based on their level of plasma fibrinogen prior to treatment(also known as Fib). Group A(23 cases)consisted of 1 g/L≤Fib<2 g/L; Group B(41 cases)consisted of 2 g/L≤Fib≤4 g/L, and Group C(22 cases)consisted of Fib>4 g/L; or patients not receiving Batroxobin medication, were assigned to group D(34 cases). Groups A, B and C received 5 Bu, 10 Bu and 15 Bu of batroxobin, respectively, for the first time based on traditional medication treatment, and Fib was rechecked 1-2 days later. Drug use was temporarily stopped if Fib was less than 1 g/L; if Fib(rechecked)was between 1 and 2 g/L, 5 Bu of batroxobin was administered; if 2 g/L was between 1 and 4 g/L, 10 Bu of batroxobin was administered; while if Fib(rechecked)was greater than 4 g/L, 15 Bu of batroxobin was administered. The entire course of treatment involved three doses of batroxobin, ranging in dosage from 15 Bu to 45 Bu. Patients in each group's total effective rate was compared with patient rates throughout the entire course of treatment. Results The average hearing threshold of patients in groups A to D improved after treatment, and the average hearing threshold before and after treatment within the group was statistically significant(P<0.05); The total effective rates of groups A to D were 56.52%, 46.34%, 63.64%, and 20.59%, respectively, with statistical significance(P<0.05). There was a statistically significant difference in total effective rates between groups A and D, B and D, C and D(P<0.05), while there was no statistically significant difference in total effective rates between groups A, B and C(P>0.05); There was no statistically significant difference in efficacy classification between the four groups of patients(P>0.05). Conclusion All four treatment methods are effective, with Group A, Group B, and Group C having better efficacy than Group D. It is believed that in the treatment of sudden deafness with full frequency decline, the addition of batroxobin has better efficacy. However, the difference in initial and maintenance doses of Batroxobin does not affect final efficacy.

Key words: Sudden sensorineural hearing loss with full frequency decline, Batroxobin, Fibrinogen, Case-control study

中图分类号:

R764.43

林育珊,卢标清. 巴曲酶个性化用药治疗全频下降型突聋[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 115-121.

LIN Yushan, LU Biaoqing. Personalized use of batroxobin in the treatment of sudden sensorineural hearing loss with full frequency decline[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 115-121.

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