[鼓室内注射与全身应用类固醇治疗特发性突发性感音神经性听力损失的荟萃分析]

[Intratympanic versus systemic steroid treatment for idiopathic sudden hearing loss: a meta-analysis].

作者信息

Ding Xiu-yong, Cui Ting-ting, Feng Guo-dong, Gao Zhi-qiang

机构信息

Department of Otorhinolaryngology, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 May;48(5):412-6.

PMID:24016567

Abstract

OBJECTIVE

To assess the effectiveness and safety of intratympanic versus systemic steroid therapy in the initial treatment of idiopathic sudden hearing loss.

METHODS

An extensive search of the literature was performed in Pubmed and other available database from January, 1980 to November, 2011. After filtering by the criteria of Cochrane Collaboration, a meta-analysis was conducted.

RESULTS

Nine studies met the criteria for meta-analysis, for idiopathic sudden hearing loss patients without diabetes received intratympanic steroid therapy, the improvement rate (RR = 1.11,95% CI = 0.96-1.28, P = 0.15) did not show any significance when compared with the patients received systemic therapy. While a significant difference of improvement rate occurred between intratympanic and systemic steroid therapy in the idiopathic sudden hearing loss patients with diabetes (RR = 1.24, 95% CI = 1.02-1.50, P = 0.03).

CONCLUSION

For the initial therapy of idiopathic sudden hearing loss patients without diabetes, systemic steroid treatment still remains the first choice, but for the idiopathic sudden hearing loss patients with diabetes, intratympanic steroid treatment should be used for the initial treatment.

摘要

目的

评估鼓室内注射与全身应用类固醇激素疗法在特发性突发性感音神经性听力损失初始治疗中的有效性和安全性。

方法

对1980年1月至2011年11月期间在Pubmed及其他可用数据库进行了广泛的文献检索。按照Cochrane协作网的标准进行筛选后，进行了荟萃分析。

结果

9项研究符合荟萃分析标准，对于无糖尿病的特发性突发性感音神经性听力损失患者，鼓室内注射类固醇激素疗法与全身应用类固醇激素疗法相比，改善率（RR = 1.11，95%CI = 0.96 - 1.28，P = 0.15）无显著差异。而在患有糖尿病的特发性突发性感音神经性听力损失患者中，鼓室内注射与全身应用类固醇激素疗法的改善率存在显著差异（RR = 1.24，95%CI = 1.02 - 1.50，P = 0.03）。