Vural Alperen, Koçyiğit İsmail, Şan Furkan, Eroğlu Eray, Ketenci İbrahim, Ünal Aydin, Tokgöz Bülent, Ünlü Yaşar
Erciyes University, Department of Otorhinolaryngology, Kayseri/Turkey
Erciyes University, Department of Internal Medicine, Division of Nephrology, Kayseri/Turkey.
Perit Dial Int. 2018 Jan-Feb;38(1):57-62. doi: 10.3747/pdi.2017.00133. Epub 2017 Nov 2.
The aim of the study is to evaluate the long-term protective effect of N-acetylcysteine (NAC), an antioxidant agent, against aminoglycoside (AG)-induced ototoxicity.
A total of 40 patients receiving continuous ambulatory peritoneal dialysis (CAPD) and having their first peritonitis attacks and planned to be treated with AGs were enrolled in the study. They were randomized into 2 groups: 1 group received additional NAC and the other did not. All patients underwent hearing tests with pure tone audiometry (PTA) after the diagnosis, at 1 month and 12 months and at the same time the tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels were measured.
Patients taking NAC had better hearing test results in both ears at 1 month except 2,000 Hz for the left ear, which wasn't significantly different between the 2 groups. Although patients taking NAC had generally better PTA results at 12 months, differences between the 2 groups were not statistically significant. Baseline IL-6 level was significantly higher in the NAC group than the control group. Both TNF-α and IL-6 levels at 1 month were significantly lower in the NAC group than in the control group. On the other hand, there was no significant difference between the 2 groups in terms of TNF-α and IL-6 levels at 12 months.
The results of the current study showed that NAC, a potent anti-inflamatory drug, may be otoprotective, but that the effect is not long-lasting.
本研究旨在评估抗氧化剂N-乙酰半胱氨酸（NAC）对氨基糖苷类（AG）诱导的耳毒性的长期保护作用。
共有40例接受持续性非卧床腹膜透析（CAPD）且首次发生腹膜炎发作并计划接受AG治疗的患者纳入本研究。他们被随机分为2组：1组额外接受NAC，另一组不接受。所有患者在诊断后、1个月和12个月时均接受纯音听力测定（PTA）听力测试，同时测量肿瘤坏死因子（TNF）-α和白细胞介素（IL）-6水平。
除左耳2000Hz外，服用NAC的患者在1个月时双耳听力测试结果更好，两组之间无显著差异。虽然服用NAC的患者在12个月时PTA结果总体上更好，但两组之间的差异无统计学意义。NAC组的基线IL-6水平显著高于对照组。NAC组1个月时的TNF-α和IL-6水平均显著低于对照组。另一方面，两组在12个月时的TNF-α和IL-6水平无显著差异。
本研究结果表明，强效抗炎药NAC可能具有耳保护作用，但效果不持久。
