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超高剂量类固醇疗法对重度突发性感音神经性听力损失患者的治疗效果:与传统类固醇疗法的比较

Therapeutic efficacy of super-high-dose steroid therapy in patients with profound sudden sensorineural hearing loss: a comparison with conventional steroid therapy.

作者信息

Song Mee Hyun, Jung Su Young, Gu Ja Won, Shim Dae Bo

机构信息

Department of Otorhinolaryngology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.

出版信息

Acta Otolaryngol. 2021 Feb;141(2):152-157. doi: 10.1080/00016489.2020.1842493. Epub 2020 Nov 11.

Abstract

BACKGROUND

In patients with sudden sensorineural hearing loss (SSNHL), steroid therapy is an optional treatment method, but there is controversy about its dose.

OBJECTIVE

We aimed to compare the efficacy of super-high-dose steroid therapy with that of conventional steroid therapy in patients with profound SSNHL (pSSNHL).

MATERIAL AND METHODS

Fifty-two patients diagnosed with pSSNHL between March 2010 and May 2017 were divided into the following groups based on their steroid regimen: a conventional steroid regimen (prednisolone at 1.0 mg/kg/day for 10 days) was applied in Group 1, and a super-high-dose steroid regimen (prednisolone at 1.5 mg/kg/day for 14 days) was applied in Group 2. The treatment outcomes were compared between the groups at 2 and 4 weeks after the initial treatment by use of Siegel's criteria.

RESULTS

Of the 52 patients, 31 were classified into Group 1 and 21 into Group 2. When comparing the proportion of patients in complete or partial recovery by Siegel's criteria, the recovery rate was significantly higher in Group 2 than in Group 1 (19% vs 0%,  = .022 at 2 weeks; 35.7% vs 7.4%,  = 0.035 at 4 weeks).

CONCLUSIONS AND SIGNIFICANCE

Patients with pSSNHL treated using the super-high-dose steroid regimen demonstrated better recovery rates to serviceable hearing than did those treated using the conventional steroid regimen without significant complications.

摘要

背景

在突发性感音神经性听力损失(SSNHL)患者中,类固醇疗法是一种可选择的治疗方法,但关于其剂量存在争议。

目的

我们旨在比较超大量类固醇疗法与传统类固醇疗法对重度SSNHL(pSSNHL)患者的疗效。

材料与方法

将2010年3月至2017年5月间诊断为pSSNHL的52例患者根据类固醇治疗方案分为以下几组:第1组采用传统类固醇治疗方案(泼尼松龙1.0mg/kg/天,共10天),第2组采用超大量类固醇治疗方案(泼尼松龙1.5mg/kg/天,共14天)。在初始治疗后2周和4周时,采用西格尔标准比较两组的治疗结果。

结果

52例患者中,31例归入第1组,21例归入第2组。根据西格尔标准比较完全或部分恢复患者的比例时,第2组的恢复率显著高于第1组(2周时分别为19%对0%,P = 0.022;4周时分别为35.7%对7.4%,P = 0.035)。

结论与意义

采用超大量类固醇治疗方案治疗的pSSNHL患者比采用传统类固醇治疗方案的患者听力恢复到可用水平的比例更高,且无明显并发症。

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