摘要目的：探讨脑源性神经营养因子(BDNF)及其基因多态性(Val66Met)与耳鸣的关系，评价耳鸣疗效及耳鸣程度与血浆BDNF的相关性。方法：测定30例耳鸣患者（实验组）和30例健康对照者（对照组）血清BDNF水平及其基因多态性(rs 6265 Val66Met)。耳鸣严重程度使用耳鸣残疾评估量表(THI)评估。根据THI评分将耳鸣患者分为两组：轻度残疾(≤36)和中重度残疾(≥38)。所有病人使用经颅磁刺激治疗。以耳鸣残疾评估量表（THI）评分、血浆BDNF浓度治疗前后变化情况，探讨耳鸣程度及疗效与血浆BDNF浓度的关系。结果：耳鸣患者血清BDNF浓度低于健康对照组（p＜0.05）。耳鸣治疗有效患者组治疗后血清BDNF浓度高于治疗前血清BDNF（p＜0.05）；耳鸣治疗无效患者治疗前后血清BDNF浓度变化无统计学意义。在耳鸣患者和健康对照组中，BDNF（rs 6265Val66Met）基因多态性与血清BDNF浓度均无明显相关性。患者血清BDNF浓度低于健康对照组，二者的差异可能是由于耳鸣患者听觉皮层可塑性发生改变及BDNF基因在不同的组织和病理中表达不同所致。耳鸣治疗有效患者治疗后血清BDNF浓度相比治疗前显著升高，耳鸣治疗无效患者治疗前后血清BDNF浓度变化不明显。结论：BDNF的浓度与耳鸣的预后存在相关性，BDNF可能通过神经可塑性机制参与耳鸣疾病的发生；因此推测血清BDNF浓度可以作为耳鸣疗效的客观指标之一。
Abstract Objective The purpose of this study was to determine whether BDNF can be used to determine the efficacy of tinnitus, and the relationship between BDNF rs 6265 (Val66Met) gene polymorphism and peripheral blood BNDF concentration. Methods The level of BDNF and its gene polymorphism in 30 patients with tinnitus (control group) and 30 healthy controls (control group) were measured (rs 6265 Val66Met). The severity of tinnitus was assessed using the tinnitus disability assessment scale (THI). The tinnitus patient was divided into two groups according to the THI score: mild disability (CD36) and moderate to severe disability (Sup38). All patients were treated with transcranial magnetic stimulation. To study the relationship between the level of tinnitus and the concentration of brain-derived neurotrophic factor in patients with tinnitus, disability assessment scale (THI) score and plasma brain-derived neurotrophic factor concentration. Result The serum BDNF concentration in the patients with tinnitus was lower than that in the healthy control group (p <0.05). The level of BDNF in the treatment of patients with tinnitus was higher than that before treatment (p <0.05). In the patients with tinnitus and the healthy control group, there was no significant correlation between the gene polymorphism of BDNF (rs 6265 Val66Met) and the serum BDNFconcentration. The serum BDNF concentration of patients was lower than that of healthy controls, and the difference was statistically significant. The difference between the two may be due to changes in auditory cortical plasticity in patients with tinnitus and different expression of BDNF genes in different tissues and pathologies. The concentration of serum BDNF in patients with effective tinnitus treatment was significantly higher than that before treatment, which was statistically significant. The serum BDNF concentration in patients with ineffective tinnitus treatment was not significantly changed before and after treatment, so there was no statistical significance. Conclusions The concentration of BDNF is correlated with the prognosis of tinnitus, and BDNF may be involved in the occurrence of tinnitus disease through the mechanism of neuroplasticity. Therefore, it is speculated that serum BDNF concentration can be used as one of the objective indicators of tinnitus efficacy.