摘要
目的比较畸变产物耳声发射 (DPOAE)和听性脑干反应 (ABR)对庆大霉素 (GM )致聋早期诊断中的作用。一旦发现致聋后立即给予肌注谷胱苷肽 (GSH) ,观察其听力能否改善。 方法选听力正常豚鼠 40只 ,随机分DPOAE组 10只 ,ABRⅠ、Ⅱ组各 12只 (Ⅰ组为ABR出现变化后停药 ,Ⅱ组为停药后再注射GSH 5d) ,对照组 6只。实验组每日肌注GM 10 0mg/kg ,对照组注射等量盐水。用药前后采用DPOAE和ABR监测其振幅和IV波反应阈。停药 2周后行耳蜗铺片 ,观察毛细胞形态学变化。 结果DPOAE组在用GM后平均 7d出现变化 ,而ABR组平均 10d出现阈移。ABRⅠ组用GM 10d停药 2周后复查阈移呈进一步增大 (P <0 .0 1) ,而ABRⅡ组 (停药后用GSH) 2周后复查阈移无明显增大 (P >0 .0 5 )。毛细胞形态学与功能变化基本一致。 结论DPOAE较ABR能更早地发现GM耳毒性 ,及时停药听力有望不受损害 ,而ABR出现变化后 ,即使停药听力损害仍将继续加重。GSH能阻止GM对耳蜗的继续损害。
Objective Distortion product otoaconstic emission (DPOAE) was compared with auditory brain-stem response (ABR) in the early diagnosis of gentamicin (GM) ototoxicity. Whether impaired hearing could be improved with the glutathione treatment after its withdrawl of injection. Methods 40 guinea pigs with normal hearing were randomly divided into 4 groups, 10 in DPOAE group, 12 in ABR I group (the usage of GM was stopped when abnormal shift presented in ABR),12 in ABR Ⅱ (group glutathione was injected for 5 after the usage of GM had been stopped), 6 in control group. The guinea pigs in experimental group were injected with GM 100mg/kg per day, while those in the control group were injected with saline. The DPOAE and ABR were monitored to observe the amplitude and the threshold of wave IV.The morphological changes of hair cells were also observed after injection of GM had been stopped for 2 weeks. Results It was averaged at 7d after the injection of GM when the changes presented in DPOAE group, while 10d in ABR group. The threshold shift increased after the injection had been stopped for 2 weeks in ABR Ⅰ group (P< 0.01 ),while there was no obvious shift in ABR Ⅱ group. The morphological and functional changes of the hair cells were almost the same. Conclusion GM ototoxicity could be more sensitively observed by DPOAE than ABR. Glutathione could prevent further ototoxic effect of GM to the cochlear.
出处
《上海第二医科大学学报》
CSCD
2000年第6期500-502,508,共4页
Acta Universitatis Medicinalis Secondae Shanghai
