药物防治噪声性听力损失：系统评价。
Pharmacological Prevention of Noise-induced Hearing Loss: A Systematic Review.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Department of Otolaryngology-Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
出版信息
Otol Neurotol. 2021 Jan;42(1):2-9. doi: 10.1097/MAO.0000000000002858.
OBJECTIVE
This study aims to explore and determine the effectiveness of current pharmacologic agents for the prevention of noise-induced hearing loss (NIHL) via a systematic review.
DATABASES REVIEWED
The PubMed, Scopus, ClinicalTrials.gov, and Cochrane Library databases were searched from inception through February 6, 2020.
METHODS
Full-text, English-language articles detailing prospective randomized and nonrandomized clinical trials with pharmacological interventions administered to prevent NIHL were included in accordance with PRISMA guidelines. The detailed search terms are included in the Appendix, http://links.lww.com/MAO/B67.
RESULTS
Eleven articles were included in this review with 701 patients receiving a pharmacologic prevention for various noise exposures. Various regimens included administration of alpha-lipoic acid, ambient oxygen, beta-carotene, carbogen, ebselen, Mg-aspartate, N-acetylcysteine, and vitamins C, E, and B12. A number of studies demonstrated statistically significant amelioration of NIHL with pharmacologic intervention. Two studies demonstrated significantly better hearing outcomes for pharmacological prophylaxis with carbogen or ebselen as compared with placebo for the 4 kHz frequency, where the noise-notch is most likely to be encountered. Given the considerable heterogeneity in agents and methodologies, however, it was not possible to conduct a meta-analysis.
CONCLUSIONS
While several heterogenous articles demonstrated promising results for Mg-aspartate, carbogen, vitamin B12, and alpha-lipoic acid, the clinical significance of these pharmaceuticals remains unclear. Initial data from this study alongside future clinical trials might potentially contribute to the generation of clinical practice guidelines to prevent NIHL.
LEVEL OF EVIDENCE
目的
本研究旨在通过系统评价探讨和确定当前用于预防噪声性听力损失（NIHL）的药物的效果。
数据库检索
从建库到 2020 年 2 月 6 日，检索了 PubMed、Scopus、ClinicalTrials.gov 和 Cochrane Library 数据库。
方法
根据 PRISMA 指南，纳入了详细描述药物干预预防 NIHL 的前瞻性随机和非随机临床试验的全文英文文章。详细的搜索词见附录，http://links.lww.com/MAO/B67。
结果
本综述纳入了 11 篇文章，共 701 例患者接受了各种噪声暴露的药物预防。各种方案包括α-硫辛酸、环境氧、β-胡萝卜素、碳氧、艾地苯醌、Mg-天冬氨酸、N-乙酰半胱氨酸和维生素 C、E、B12 的给药。许多研究表明，药物干预可显著改善 NIHL。有两项研究表明，与安慰剂相比，碳氧或艾地苯醌的药物预防在 4 kHz 频率（最有可能遇到噪声凹陷）下具有更好的听力结果，这两项研究具有统计学意义。然而，由于药物和方法学的异质性很大，因此无法进行荟萃分析。
结论
虽然有几篇异质文章表明 Mg-天冬氨酸、碳氧、维生素 B12 和 α-硫辛酸有很有前景的结果，但这些药物的临床意义仍不清楚。本研究的初步数据以及未来的临床试验可能有助于制定预防 NIHL 的临床实践指南。
证据水平
2。
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