巴曲酶治疗全频下降型突发性聋的疗效观察及与凝血功能相关性分析
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陆军军医大学大坪医院耳鼻咽喉-头颈外科 重庆

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The observation of the curative effect of Batroxobin on the sudden deafness with the total frequency drop and the correlation between the treatment and coagulation function
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    摘要:

    目的:探讨巴曲酶治疗全频下降型突发性聋的疗效与巴曲酶敏感性及凝血功能相关指标的相关性。方法:回顾性分析我院2019年1月-2021年2月全频下降型突发性聋患者48例,根据患者纤维蛋白原的变化分为敏感组及非敏感组,检测患者凝血功能包括活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)及纤维蛋白原(FIB)的变化、治疗前后纯音听阈变化。结果:(1)巴曲酶非敏感组患者的总有效率低于巴曲酶敏感组患者,差异有统计学意义(P=0.043)。治疗10-14d后,巴曲酶敏感组听阈提高绝对值与非敏感组相比,差异无统计学意义(P=0.28)(2)48例患者治疗前后凝血功能比较,FIB、APTT较治疗前下降(P<.05),TT、PT较治疗前提高(P<.05)。(3)巴曲酶敏感组与非敏感组患者治疗前凝血功能(FIB、TT、APTT、PT)比较差异均无统计学意义(P>0.05);两组患者治疗后FIB与治疗前相比均下降(P<0.05),且敏感组低于非敏感组(P<0.05),TT均增高(P<.05),且敏感组高于非敏感组;敏感组治疗后较治疗前PT增高(P<0.05),APTT降低(P<0.05);非敏感组APTT、PT治疗后与治疗前比较,差异无统计学意义(P>0.05);治疗后敏感组较非敏感组PT提高(P<0.05),APTT差异无统计学意义。结论:巴曲酶敏感性与临床治疗效果具有相关性,这与FIB、PT、TT密切相关,与APTT相关性不大,但机体可能通过APTT内源性凝血功能,降低出血风险。巴曲酶可增强抗凝血功能,促进内耳微循环,通过使抗凝、纤溶和凝血保持在一定的平衡范围内,降低风险。

    Abstract:

    Objectiv To investigate the effect of Batroxobin in the treatment of sudden deafness with full frequency decline and its correlation with batroxobin sensitivity and coagulation function. Method A retrospective analysis of 48 cases of sudden deafness with full frequency decline from January 2019 to February 2021 in our hospital was conducted. According to the changes of fibrinogen, the patients were divided into sensitive group and non sensitive group. The coagulation function of the patients was detected, including the changes of activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB), and the changes of pure tone hearing threshold before and after treatment. Results (1) The total effective rate of non batroxobin sensitive group was lower than that of batroxobin sensitive group (P = 0.043). After 10-14 days of treatment, there was no significant difference in absolute value of hearing threshold improvement between batroxobin sensitive group and non sensitive group (P = 0.28) (2) FIB and APTT decreased (P < 0.05), TT and Pt increased (P < 0.05) in 48 patients before and after treatment. (3) There was no significant difference in coagulation function (FIB, TT, APTT, PT) between batroxobin sensitive group and non sensitive group before treatment (P > 0.05); FIB of the two groups decreased after treatment (P < 0.05), And the sensitive group was lower than the non sensitive group (P < 0.05), TT was increased (P < 0.05), and the sensitive group was higher than the non sensitive group; the PT of the sensitive group was higher than that before treatment (P < 0.05), APTT was lower than that before treatment (P < 0.05); the APTT and Pt of the non sensitive group had no significant difference compared with that before treatment (P > 0.05); the PT of the sensitive group was higher than that of the non sensitive group after treatment (P < 0.05), APTT had no significant difference righteousness Conclusion Batroxobin sensitivity is closely related to clinical treatment effect, which is closely related to fib, Pt and TT, and is not related to APTT. However, the body may reduce the risk of bleeding through the endogenous coagulation function of APTT. Batroxobin can enhance anticoagulant function, promote inner ear microcirculation, and reduce risk by keeping anticoagulation, fibrinolysis and coagulation in a certain balance.

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  • 收稿日期:2021-08-03
  • 最后修改日期:2021-10-25
  • 录用日期:2021-10-28
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