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鼓室内地塞米松和维生素 E 对顺铂诱导的耳毒性的保护作用在大鼠中得到证实。

The protective effects of intratympanic dexamethasone and vitamin E on cisplatin-induced ototoxicity are demonstrated in rats.

机构信息

2nd ENT Department, Kartal Training and Research Hospital, Istanbul, Turkey.

出版信息

Med Oncol. 2011 Jun;28(2):615-21. doi: 10.1007/s12032-010-9477-4. Epub 2010 Mar 19.

Abstract

Cisplatin ototoxicity is a major dose-limiting factor in the treatment of several neoplasms. Dexamethasone and vitamin E are two slow-acting free radical cleaners, and they have been shown to ameliorate nephrotoxicity and endothelial cell damage in animals receiving cisplatin. The purpose of the study was to determine the effectiveness of vitamin E and dexamethasone as an otoprotectant intratympanically. Prospective, randomized controlled trial in the rat model. Wistar rats were sedated using 50 mg/kg intraperitoneal ketamine and 7.5 mg/kg xylazine. Baseline auditory brainstem response (ABR) testing was performed in response to clicks and 4.8-, 12-, 16-kHz tone bursts. After auditory thresholds were determined, the animals received intraperitoneal drug administration according to one of the four groups. The rat groups received (group I) % 09 NaCl solution intratympanically (IT), (group II) cisplatin (20 mg/kg) only intraperitoneally (IP), (group III) dexamethasone (0.1-0.3 ml) IT and (group IV) vitamin E solution (0.1-0.3 ml) IT followed after 30 min by 20 mg/kg cisplatin. After the 3-day follow-up, ABR testing was performed and threshold changes were recorded. Group II animals showed marked hearing loss with average threshold shifts of 39.7 ± 1.4 dB for clicks, 7.3 ± 2.6 dB at 4 kHz, 8.4 ± 1.6 dB at 8 kHz, 71.1 ± 4.2 dB at 12 kHz and 71.9 ± 5.9 dB at 16 kHz. No significant loss was observed in group III with shifts of 1.60 ± 1.3 dB, 4.75 ± 2.4 dB, 8.7 ± 3.4 dB, and 4.3 ± 2.1 dB for clicks and tone bursts at 4.8, 12, and 16 kHz, respectively. And similar findings were observed in group IV with shifts of 3.3 ± 1.4 dB, 7.2 ± 2.1 dB, 10.8 ± 2 dB, and 13.3 ± 3.1 dB for clicks and tone bursts at 4.8, 12, and 16 kHz, respectively. Significant protection was seen in group III and IV animals compared with group II animals. There is no side effect in IT administration of vitamin E and dexamethasone for hearing functions and two of them appear to have a easier, safer, usable protective effect against cisplatin ototoxicity.

摘要

顺铂耳毒性是几种肿瘤治疗中的主要剂量限制因素。地塞米松和维生素 E 是两种缓慢作用的自由基清除剂,已证明它们可改善接受顺铂治疗的动物的肾毒性和内皮细胞损伤。本研究旨在确定维生素 E 和地塞米松作为鼓室内耳保护剂的有效性。在大鼠模型中进行前瞻性、随机对照试验。Wistar 大鼠用 50mg/kg 腹腔内氯胺酮和 7.5mg/kg 甲苯噻嗪镇静。对点击和 4.8、12、16kHz 声爆发进行基线听觉脑干反应(ABR)测试。确定听觉阈值后,根据以下四个组之一对动物进行腹腔内药物给药。大鼠组分别接受(I 组)鼓室内 0.09%生理盐水(IT)、(II 组)仅腹腔内顺铂(20mg/kg)、(III 组)地塞米松(0.1-0.3ml)IT 和(IV 组)维生素 E 溶液(0.1-0.3ml)IT,30 分钟后给予 20mg/kg 顺铂。经过 3 天的随访,进行 ABR 测试并记录阈值变化。II 组动物表现出明显的听力损失,点击平均阈值变化为 39.7±1.4dB,4kHz 为 7.3±2.6dB,8kHz 为 8.4±1.6dB,12kHz 为 71.1±4.2dB,16kHz 为 71.9±5.9dB。III 组无明显损失,点击和 4.8、12、16kHz 声爆发的阈值变化分别为 1.60±1.3dB、4.75±2.4dB、8.7±3.4dB 和 4.3±2.1dB。IV 组也有类似的发现,点击和 4.8、12、16kHz 声爆发的阈值变化分别为 3.3±1.4dB、7.2±2.1dB、10.8±2dB 和 13.3±3.1dB。与 II 组动物相比,III 组和 IV 组动物有明显的保护作用。维生素 E 和地塞米松鼓室内给药对听力功能没有副作用,两者似乎都具有对抗顺铂耳毒性的更简单、更安全、更可用的保护作用。

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