[鼓膜内注射N-乙酰半胱氨酸对顺铂耳毒性的疗效]
[Efficacy of intratympanic infiltration of N-acetyl cysteine in cisplatin ototoxicity].
作者信息
Rosas-Gutiérrez Goretti Del Carmen, Fernández-Hernández Juan Pablo, Olea-González Atzin Itaí
机构信息
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello. León, Guanajuato, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Terapia Intensiva. León, Guanajuato, México.
出版信息
Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S318-S322.
INTRODUCTION
Currently there is no approved preventive or therapeutic pharmacological treatment to treat ototoxicity caused by cisplatin. N-acetyl cysteine (NAC) is a safe and inexpensive antioxidant that has been studied as an otoprotective alternative.
OBJECTIVE
To describe the efficacy of intratympanic infiltration of NAC as prevention and treatment of ototoxicity induced in patients treated with cisplatin.
MATERIAL AND METHODS
Open, longitudinal, prospective, randomized clinical trial in cancer patients treated with cisplatin who met the inclusion criteria. Out of the sample of 22 patients, 11 underwent intratympanic NAC infiltration and 11 were taken as a control group. It was performed an audiometry at the beginning and one month after on all patients.
RESULTS
A sample of 22 patients with a mean age of 53 (±13) was collected. In our sample of 11 patients with infiltration in both ears, 1 ear showed improvement; on the other hand, in the control group that was not infiltrated, 4 showed an increase in hearing loss from mild to moderate in all 4 cases, 2 in the left ear and 2 in the right ear (Spearman's Rho = 0.93, p ≤ 0.001). Relative risk was of 1.22.
CONCLUSIONS
An association can be observed that intratympanic NAC could become an alternative for the prevention and treatment of cisplatin-induced ototoxicity.
引言
目前尚无经批准的预防或治疗顺铂所致耳毒性的药物治疗方法。N-乙酰半胱氨酸（NAC）是一种安全且廉价的抗氧化剂，已作为一种耳保护替代方法进行研究。
目的
描述鼓室内注入NAC预防和治疗顺铂治疗患者耳毒性的疗效。
材料与方法
对符合纳入标准的接受顺铂治疗的癌症患者进行开放性、纵向、前瞻性、随机临床试验。在22例患者样本中，11例接受鼓室内NAC注入，11例作为对照组。所有患者在开始时和1个月后进行听力测定。
结果
收集了22例平均年龄为53（±13）岁的患者样本。在我们双耳注入的11例患者样本中，1只耳朵显示有改善；另一方面，在未注入的对照组中，4例均显示听力损失从轻度增加到中度，左耳2例，右耳2例（Spearman秩相关系数=0.93，p≤0.001）。相对风险为1.22。
结论
可以观察到鼓室内NAC可能成为预防和治疗顺铂所致耳毒性的一种替代方法。
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