Chang Po-Hsiung, Liu Chia-Wei, Hung Shih-Han, Kang Yi-No
Department of Otolaryngology Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Arch Med Sci. 2021 Mar 21;18(6):1535-1541. doi: 10.5114/aoms/109126. eCollection 2022.
Noise-induced hearing loss is one of the most prevalent causes of hearing impairment and occupational diseases. Although multiple factors lead to noise-induced hearing loss, prevention and protection strategies remain limited. Studies in the past decade have employed antioxidants, especially N-acetyl-cysteine, to prevent noise-induced hearing loss. Therefore, this systematic review and meta-analysis of randomized controlled trials evaluated the effect of N-acetyl-cysteine on the prevention of noise-induced hearing loss.
This systematic review and meta-analysis included relevant studies from the Cochrane Library, EMBASE, PubMed, ScienceDirect, Scopus, and Web of Science by using related terms. The study only included randomized controlled trials in meta-analyses and assessed the quality of the identified randomized controlled trials by using the Cochrane Risk of Bias tool. Two authors extracted and calculated data on characteristics and hearing threshold. The results are presented as weighted mean difference (WMD) with 95% confidence interval (CI).
This study identified five randomized controlled trials that randomized 1,115 patients into N-acetyl-cysteine and control groups. The meta-analysis evidenced that N-acetyl-cysteine has greater protective effects against hearing threshold shifts than the control in the 0 to 4 kHz (WMD = -3.39, 95% CI: -6.56 to -0.22) and 0 to 6 kHz (MD = -3.49, 95% CI: -6.57 to -0.41) subgroups.
The present review and meta-analysis recommends that N-acetyl-cysteine may be considered as an option for protective therapy for noise-induced hearing loss. Nonetheless, larger randomized controlled trials are requisite for further investigation and verification.
噪声性听力损失是听力障碍和职业病最常见的原因之一。尽管多种因素导致噪声性听力损失，但预防和保护策略仍然有限。过去十年的研究采用抗氧化剂，尤其是N-乙酰半胱氨酸，来预防噪声性听力损失。因此，本随机对照试验的系统评价和荟萃分析评估了N-乙酰半胱氨酸对预防噪声性听力损失的效果。
本系统评价和荟萃分析通过使用相关术语，纳入了来自Cochrane图书馆、EMBASE、PubMed、ScienceDirect、Scopus和Web of Science的相关研究。该研究在荟萃分析中仅纳入随机对照试验，并使用Cochrane偏倚风险工具评估所识别随机对照试验的质量。两位作者提取并计算了有关特征和听力阈值的数据。结果以加权平均差（WMD）和95%置信区间（CI）表示。
本研究识别出五项随机对照试验，将1115名患者随机分为N-乙酰半胱氨酸组和对照组。荟萃分析表明，在0至4kHz（WMD = -3.39，95%CI：-6.56至-0.22）和0至6kHz（MD = -3.49，95%CI：-6.57至-0.41）亚组中，N-乙酰半胱氨酸对听力阈值变化的保护作用比对照组更大。
本综述和荟萃分析建议，N-乙酰半胱氨酸可被视为噪声性听力损失保护治疗的一种选择。尽管如此，仍需要更大规模的随机对照试验进行进一步研究和验证。
