Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710068, Shaanxi, China.
Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Medical Research School of Northwestern Polytechnical University, 710068, Shaanxi, China.
Thromb Res. 2020 Apr;188:31-38. doi: 10.1016/j.thromres.2020.01.023. Epub 2020 Jan 23.
To evaluate the treatment outcome of vasodilator prostaglandin E1 (PGE1) in treating sudden sensorineural hearing loss (SSNHL) and to determine its effects on platelet activation, as reflected by changes in CD62p and PAC-1.
We prospectively enrolled 60 patients with confirmed SSNHL and randomly divided them into two groups: the SSNHL group received regular therapy, and the SSNHL-PGE1 group received additional intravenous injection of PGE1. After 14 days of treatment, we measured clinical improvement and CD62p-positive and PAC-1-positive platelets. 30 healthy medical staff members were included as a control group.
The SSNHL patients had significantly higher levels of CD62p-positive or PAC-1 positive platelets than the healthy subjects. The ratios of CD62p positive or PAC-1 positive platelets significantly decreased after the two treatments. The average pure tone (PTA) hearing thresholds decreased to 26.51 ± 12.65 dB in SSNHL-PGE1 group after treatment, which was significantly lower than that of the SSNHL group (34.46 ± 10.35 dB). Patients with initial severe or profound hearing loss (PTA ≥ 71 dB) had better hearing improvement on PGE1 than on the regular treatment. Patients in the SSNHL-PGE1 treatment group had significantly lower CD62p and PAC-1 levels than those in the SSNHL group. Patients with higher initial positive CD62p and PAC-1 ratios tended to have higher potential of clinical improvement and hearing gains after PGE1 treatment. Initial CD62p and PAC-1 levels were significantly correlated with hearing thresholds in patients with SSNHL.
PGE1 application could improve treatment efficacy and suppress excessive platelet activation in patients with SSNHL.
评估血管扩张性前列腺素 E1(PGE1)治疗突发性聋(SSNHL)的治疗效果,并通过 CD62p 和 PAC-1 的变化来确定其对血小板活化的影响。
我们前瞻性地纳入了 60 例确诊的 SSNHL 患者,并将其随机分为两组:SSNHL 组接受常规治疗,SSNHL-PGE1 组接受额外的静脉注射 PGE1。治疗 14 天后,我们测量了临床改善情况和 CD62p 阳性和 PAC-1 阳性血小板。30 名健康医务人员作为对照组。
SSNHL 患者的 CD62p 阳性或 PAC-1 阳性血小板水平明显高于健康受试者。两种治疗后,CD62p 阳性或 PAC-1 阳性血小板的比例均显著降低。SSNHL-PGE1 组治疗后平均纯音听阈(PTA)降至 26.51±12.65dB,明显低于 SSNHL 组(34.46±10.35dB)。初始严重或极重度听力损失(PTA≥71dB)的患者在 PGE1 治疗上的听力改善优于常规治疗。SSNHL-PGE1 治疗组患者的 CD62p 和 PAC-1 水平明显低于 SSNHL 组。初始 CD62p 和 PAC-1 比值较高的患者在 PGE1 治疗后更有可能出现临床改善和听力提高。初始 CD62p 和 PAC-1 水平与 SSNHL 患者的听力阈值显著相关。
PGE1 的应用可提高 SSNHL 患者的治疗效果并抑制血小板过度活化。