Lan Wei-Che, Wang Ching-Yuan, Lin Chia-Der
China Medical University Hospital, Otolaryngology Head and Neck Surgery, Taichung City, Taiwan.
J Int Adv Otol. 2018 Aug;14(2):176-180. doi: 10.5152/iao.2018.4690.
To compare the efficacy of pentoxifylline with that of conventional steroid therapy in diabetic patients with idiopathic sudden sensorineural hearing loss (ISSNHL) and to compare blood sugar levels during hospitalization.
Medical charts were retrospectively reviewed for all diabetic patients admitted to one institution for ISSNHL between 2000 and 2015. We analyzed 298 cases; 50 patients received pulse steroid treatment (steroid group) and 248 received intravenous administration of pentoxifylline only (pentoxifylline group). Hearing change was evaluated by comparing the initial hearing tests with follow-up hearing tests for up to 3 months. Blood sugar levels were also compared between the 2 groups.
At 3 months post-treatment, the degree of hearing recovery was similar between the 2 groups. The pure-tone average was improved from baseline by 17.9±21.2 dB in the steroid group and 18.9±20.7 dB in the pentoxifylline group (p=0.776); hearing recovery rates were also similar (40% vs 39.1%; p=0.826). During hospitalization, average fasting blood sugar levels were higher (203.9±92.0 vs 174.4±54.8 mg/dL; p=0.033) and acute hyperglycemia was more common (48.0% vs 33.1%; p=0.044) with steroid versus pentoxifylline treatment.
Hearing recovery rates did not significantly differ between steroid and pentoxifylline treatment in diabetic patients with ISSNHL, but pentoxifylline appeared to be associated with better blood sugar control.
比较己酮可可碱与传统类固醇疗法对糖尿病伴特发性突发性感音神经性听力损失(ISSNHL)患者的疗效,并比较住院期间的血糖水平。
回顾性分析2000年至2015年期间一所机构收治的所有糖尿病伴ISSNHL患者的病历。我们分析了298例病例;50例患者接受脉冲类固醇治疗(类固醇组),248例仅接受静脉注射己酮可可碱(己酮可可碱组)。通过比较初始听力测试与长达3个月的随访听力测试来评估听力变化。还比较了两组之间的血糖水平。
治疗后3个月,两组的听力恢复程度相似。类固醇组的纯音平均听阈较基线提高了17.9±21.2 dB,己酮可可碱组提高了18.9±20.7 dB(p = 0.776);听力恢复率也相似(40%对39.1%;p = 0.826)。住院期间,类固醇治疗组的平均空腹血糖水平较高(203.9±92.0对174.4±54.8 mg/dL;p = 0.033),急性高血糖更常见(48.0%对33.1%;p = 0.044)。
在糖尿病伴ISSNHL患者中,类固醇和己酮可可碱治疗的听力恢复率无显著差异,但己酮可可碱似乎与更好的血糖控制相关。