Mora Renzo, Dellepiane Massimo, Mora Francesco, Jankowska Barbara
Ear, Nose, and Throat Department, University of Genoa, Genoa, Italy.
Int Tinnitus J. 2005;11(2):181-4.
We treated 80 patients with sudden hearing loss and 70 patients with chronic decreasing cochlear function to date with intravenous infusion of a glycoprotein analogous to recombinant tissue-type plasminogen activator (rt-PA): 3 mg dissolved in 250 mg of physiological saline given every 12 hours intravenously. Specifically excluded were patients with known abnormal coagulation. We treated no patient for longer than 20 days. Before therapy, 6 months therapy began, and at the end of treatment, all patients underwent the following instrumental examinations: prothrombin and fibrinogen level measurements, liminal tonal audiometry, tympanometry, and assessment of otoacoustic emissions and otoacoustic products of distortion. Daily during the treatment, we monitored the patients by liminal tonal audiometry and assessment of otoacoustic emissions with linear click emission and otoacoustic products of distortion. We discharged patients when their audibility threshold stabilized. No patient experienced side effects due to the treatment, and functional results were excellent in all (even more so if compared with the protocols of therapy previously used for these kinds of diseases). The tissue plasminogen activator was used with remarkable success for the treatment of sudden hearing loss; this study shows remarkable success with a very low dose of rt-PA as compared to the standard dosage used for treatment of myocardial infarction.
迄今为止，我们对80例突发性听力损失患者和70例慢性耳蜗功能减退患者进行了静脉输注一种类似于重组组织型纤溶酶原激活剂（rt-PA）的糖蛋白治疗：将3 mg溶解于250 mg生理盐水中，每12小时静脉给药一次。已知凝血异常的患者被明确排除。我们对任何患者的治疗时间均不超过20天。在治疗前、治疗开始6个月以及治疗结束时，所有患者均接受了以下仪器检查：凝血酶原和纤维蛋白原水平测定、阈限纯音听力测定、鼓室导抗图检查以及耳声发射和畸变产物耳声发射评估。在治疗期间，每天通过阈限纯音听力测定以及使用线性短声发射和畸变产物耳声发射评估对患者进行监测。当患者的听阈稳定后予以出院。没有患者因治疗出现副作用，所有患者的功能结果均非常好（与以前用于这类疾病的治疗方案相比更是如此）。组织纤溶酶原激活剂用于治疗突发性听力损失取得了显著成功；与用于治疗心肌梗死的标准剂量相比，本研究显示极低剂量的rt-PA也取得了显著成功。
