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甲泼尼龙与地塞米松用于控制确诊梅尼埃病患者眩晕的比较

Methylprednisolone versus Dexamethasone for Control of Vertigo in Patients with Definite Meniere's disease.

作者信息

Masoumi Elham, Dabiri Sasan, Khorsandi Ashtiani Mohammad Taghi, Erfanian Reza, Sohrabpour Saeed, Yazdani Nasrin, Safaee Alireza, Firouzifar Mohammadreza

机构信息

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Otorhinolaryngol. 2017 Nov;29(95):341-346.

Abstract

INTRODUCTION

Definite Meniere's disease is associated with two or more definitive periods of vertigo along with hearing loss, plus tinnitus or aural fullness or both. This study aimed to compare the effect of intratympanic dexamethasone and methylprednisolone on the functional-level scale of pure-tone audiometry (PTA), and class outcome measures of vertigo.

MATERIALS AND METHODS

In this clinical study, 69 patients with definite Meniere's disease, referred to the tertiary otolaryngology center, were randomly assigned to two groups: 36 patients were treated with intratympanic dexamethasone (4mg/dl) and 33 patients were treated with i months, PTA changes and vertigo control were evaluated.

RESULTS

There was no statistically significant difference between the two groups with regard to control of vertigo (P=0.866, P=0.879 for 1 and 6 months post injection, respectively). PTA improvement was statistically significantly higher in the methylprednisolone group (P=0.006).

CONCLUSION

In summary, intratympanic corticosteroid is an effective treatment for Meniere's disease and can prevent other invasive treatments. Intratympanic methylprednisolone can improve hearing level to a greater extent than intratympanic dexamethasone, but the two groups were similarly beneficial in controlling vertigo. However, there was a trend toward a more sustained benefit with methylprednisolone.

摘要

引言

确诊的梅尼埃病与两个或更多明确的眩晕期相关,同时伴有听力损失,以及耳鸣或耳闷胀感或两者皆有。本研究旨在比较鼓室内注射地塞米松和甲泼尼龙对纯音听力计(PTA)功能水平量表以及眩晕分级结果指标的影响。

材料与方法

在这项临床研究中,69例确诊为梅尼埃病的患者被转诊至三级耳鼻喉科中心,随机分为两组:36例患者接受鼓室内注射地塞米松(4mg/dl)治疗,33例患者接受鼓室内注射甲泼尼龙治疗。治疗1个月和6个月后,评估PTA变化和眩晕控制情况。

结果

两组在眩晕控制方面无统计学显著差异(注射后1个月和6个月时,P分别为0.866和0.879)。甲泼尼龙组的PTA改善在统计学上显著更高(P = 0.006)。

结论

总之,鼓室内注射皮质类固醇是治疗梅尼埃病的有效方法,可避免其他侵入性治疗。鼓室内注射甲泼尼龙比鼓室内注射地塞米松能更大程度地改善听力水平,但两组在控制眩晕方面同样有效。然而,甲泼尼龙有带来更持久益处的趋势。

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