Suzuki Mitsuya, Otake Rika, Kashio Akinori
Department of Otolaryngology, Tokyo Metropolitan Police Hospital, Fujimi, Tokyo, Japan.
ORL J Otorhinolaryngol Relat Spec. 2006;68(3):170-6. doi: 10.1159/000091343. Epub 2006 Feb 6.
We retrospectively analyzed 225 patients with acute low-tone sensorineural hearing loss (ALSHL), comparing the effectiveness of corticosteroid and diuretic therapy, and also determining the factors affecting hearing recovery.
Retrospective clinical record review.
Multivariate logistic regression analysis.
Analyses identified unfavorable factors such as aging, late initiation of treatment, and pretreatment pure-tone hearing thresholds at three lower frequencies adding up to 95 dB and more. Multivariate logistic regression analysis indicated a significantly greater improvement in hearing in patients treated with corticosteroids at high initial and total doses than in those treated with vitamin B12 and ATP without adding corticosteroids. In 145 patients treated with corticosteroids, multivariate logistic regression analysis showed a trend toward greater improvement with high initial and total doses than with low doses.
Corticosteroids should be changed from low to high doses within 7 days after onset of ALSHL, if low doses are failing.
我们回顾性分析了225例急性低频感音神经性听力损失（ALSHL）患者，比较了皮质类固醇和利尿剂治疗的效果，并确定了影响听力恢复的因素。
回顾性临床记录审查。
多因素逻辑回归分析。
分析确定了一些不利因素，如年龄增长、治疗开始较晚以及三个较低频率的治疗前纯音听力阈值总和达到95dB及以上。多因素逻辑回归分析表明，初始和总剂量较高的皮质类固醇治疗患者的听力改善明显大于未添加皮质类固醇的维生素B12和ATP治疗患者。在145例接受皮质类固醇治疗的患者中，多因素逻辑回归分析显示，初始和总剂量较高的患者比低剂量患者有更大的改善趋势。
如果低剂量皮质类固醇治疗无效，则应在ALSHL发病后7天内将其从低剂量改为高剂量。
