高剂量葡萄糖皮质类药物用于治疗突然听力丧失
Stefan K Plontke1, Matthias Girndt2, Christoph Meisner3
1Department of Otorhinolaryngology, Head & Neck Surgery, University Medicine Halle, Halle (Saale), Germany.
高剂量的全身葡萄皮质类药物用于异形突发性神经感官听力损失 (ISSNHL) 没有显示较低剂量的益处. 这些密集治疗增加了不良事件的风险,这表明标准剂量方案是管理ISSNHL的首选.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 内分泌学 在内分泌学.
- 临床药理学 临床药理学
背景情况:
- 系统性皮质糖类药物是治疗异形突发感应神经听力损失 (ISSNHL) 的基石.
- 高剂量与低剂量葡萄糖皮质类药物治疗方案对ISSNHL的比较疗效和安全性尚未得到充分证实.
研究的目的:
- 在ISSNHL患者中,比较高剂量静脉注射普雷迪尼索隆 (HD-Pred),高剂量口服德克萨米他松 (HD-Dex) 和标准口服普雷迪尼索隆疗法 (Pred-Control) 的有效性和安全性.
主要方法:
- 一项随机试验分配了325名ISSNHL患者接受HD-Pred (250 mg/天IV 5天),HD-Dex (40 mg/天口服5天) 或Pred-Control (60 mg/天口服5天,然后逐渐减少).
- 主要结局是30天后听力值 (纯音调平均值) 的变化.
- 其次结果包括语音理解,耳,沟通能力,生活质量以及代谢/心血管副作用.
主要成果:
- 在HD-Pred,HD-Dex和Pred-Control组之间没有观察到听力改善的显著差异 (P=0.09).
- 高剂量疗法 (HD-Pred和HD-Dex) 与标准剂量前控制组相比,与更高的不良事件发生率有关.
- 平均听力值的变化为34.2dB (HD-Pred),41.4dB (HD-Dex) 和41.0dB (Pred-Control). 听力值的平均变化为34.2dB (HD-Pred),41.4dB (HD-Dex) 和41.0dB (Pred-Control). 听力值的平均变化为34.2dB (HD-Pred),41.4dB (HD-Dex),和41.0dB (Pred-Control). 听力值的平均变化为34.2dB (HD-Pred),41.4dB (HD-Dex),和41.0dB (Pred-Control). 听力值的平均变化为34.2dB (HD-Pred),41.4dB (HD-Dex),和41.0dB (Pred-Control). 听力值的平均变化为2dB.
结论:
- 高剂量全身葡萄糖皮质激素治疗对治疗ISSNHL的标准低剂量疗法没有优势.
- 对ISSNHL的强化葡萄糖皮质类药物治疗增加了不良事件的风险,但没有提供额外的治疗益处.
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