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两种不同鼓室内类固醇方案预防顺铂耳毒性的疗效:一项实验研究。

Efficacy of 2 Different Intratympanic Steroid Regimen on Prevention of Cisplatin Ototoxicity: An Experimental Study.

机构信息

Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kırıkkale Yuksek Ihtısas Hospital, Kırıkkale, Turkey.

Division of Head and Neck Surgery, Department of Otorhinolaryngology, Kırıkkale University School of Medicine, Kırıkkale, Turkey.

出版信息

Ear Nose Throat J. 2021 Jul;100(6):417-422. doi: 10.1177/0145561319874311. Epub 2019 Sep 30.

Abstract

Ototoxicity is the general name of cochlear and vestibular organ injury resulting from encountering various therapeutic agents and chemical substances. Cisplatin is commonly used in the treatment of many cancers. In this study, the efficacy of intratympanic steroids was compared for preventing cisplatin ototoxicity. In this study, 32 (64 ears) rats were used by separating into 4 groups. Cisplatin was administered intraperitoneally to the first group (n = 8). Methylprednisolone and then cisplatin were administered intratympanically to the second group (n = 8). On the third group (n = 8), dexamethasone and then cisplatin were administered intratympanically. To the fourth group (n = 8), 0.9% NaCl and then cisplatin were given intratympanically. Otoacoustic emission (OAE) measurements and auditory brainstem responses (ABRs) tests were performed on all groups before and 72 hours after the procedure. Pretreatment of ABR-IV values were 4.29 ± 0.19 milliseconds in group 2 and 4.27 ± 0.16 milliseconds in group 3, whereas posttreatment ABR-IV values were 4.95 ± 0.35 milliseconds in group 2 and 4.65 ± 0.26 milliseconds in group 3. The ABR-IV values were measured significantly shorter in the rats given dexamethasone and methylprednisolone, according to control and cisplatin groups ( < .001). Pretreatment of ABR I-IV interval values were 2.98 ± 0.34 milliseconds and 3.03 ± 0.42 milliseconds in group 1 and group 4, respectively, and ABR I-IV interval values in group 1 and group 4 posttreatment were 3.49 ± 0.39 milliseconds and 3.5 ± 0.39 milliseconds in group 1 and group 4, respectively. Auditory brainstem responses I-IV interval was significantly longer in the cisplatin and control group than in the rats given dexamethasone and methylprednisolone ( < .001). After cisplatin treatment, OAE amplitudes decreased significantly in group 1 and group 4 for all frequencies, while OAE values were protected in methylprednisolone and dexamethasone group ( < .001). In conclusion, it has been shown that both agents have protective effects on cisplatin ototoxicity, with dexamethasone slightly more than methylprednisolone.

摘要

耳毒性是指由于接触各种治疗药物和化学物质而导致耳蜗和前庭器官损伤的总称。顺铂常用于治疗多种癌症。在这项研究中,比较了鼓室内类固醇预防顺铂耳毒性的疗效。本研究采用 32 只(64 耳)大鼠,分为 4 组。第一组(n = 8)腹腔内给予顺铂。第二组(n = 8)先给予甲泼尼龙,然后鼓室内给予顺铂。第三组(n = 8)先给予地塞米松,然后鼓室内给予顺铂。第四组(n = 8)给予 0.9%生理盐水,然后鼓室内给予顺铂。所有组均在术前和术后 72 小时进行耳声发射(OAE)测量和听性脑干反应(ABR)测试。预处理 ABR-IV 值在第 2 组为 4.29 ± 0.19 毫秒,第 3 组为 4.27 ± 0.16 毫秒,而第 2 组和第 3 组的术后 ABR-IV 值分别为 4.95 ± 0.35 毫秒和 4.65 ± 0.26 毫秒。与对照组和顺铂组相比,给予地塞米松和甲泼尼龙的大鼠 ABR-IV 值明显缩短(<0.001)。预处理 ABR I-IV 间隔值在第 1 组和第 4 组分别为 2.98 ± 0.34 毫秒和 3.03 ± 0.42 毫秒,第 1 组和第 4 组的 ABR I-IV 间隔值在术后分别为 3.49 ± 0.39 毫秒和 3.5 ± 0.39 毫秒。与给予地塞米松和甲泼尼龙的大鼠相比,顺铂和对照组的听觉脑干反应 I-IV 间隔明显延长(<0.001)。顺铂治疗后,第 1 组和第 4 组各频率 OAE 幅度均明显下降,而甲泼尼龙和地塞米松组 OAE 值得到保护(<0.001)。结论:两种药物均对顺铂耳毒性有保护作用,地塞米松的作用略强于甲泼尼龙。

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