ABSTRACT
Objective To analyze the curative effect and related influencing factors of hyperbaric oxygen combined with dexamethasone in the treatment of sudden deafness (SD). Methods The clinical data of 200 patients with SD, who were treated with hyperbaric oxygen combined with dexamethasone in our hospital from January 2014 to December 2016, were retrospectively analyzed.According to the curative effect,patients were divided into the effective group(n=182)and the ineffective group(n=18).Data of gender,age,time from onset to treatment,ears,hearing loss,the type of audiometric curve, dizziness, tinnitus, complications (hypertension or diabetes), plasma viscosity and serum C reactive protein (CRP) were compared between the two groups.Logistic regression analysis was used to screen risk factors influencing the curative effect of SD.Results The total response rate was 91.00%(182/200),and the ineffective rate was 9.00%(18/200).In the effective group patients aged > 50 years old, the time from onset to treatment was > 7 d, and the hearing loss was ≥ 60 dB. The proportions of high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes, plasma viscosity ≥ 2 mPa·s and serum CRP level ≥ 20 μmol/L were significantly lower in the effective group than those in the ineffective group(P<0.05).Logistic regression analysis showed that age(>50 years old),time from onset to treatment(>7 d), hearing loss(≥60 dB), high-frequency or stone-deaf audiometric curves, combined with dizziness, hypertension, diabetes, plasma viscosity(≥2 mPa·s)and plasma CRP(≥20 μmol/L)were high risk factors for the curative effect of SD(P<0.05). Conclusion Hyperbaric oxygen combined with dexamethasone is an effective treatment for SD,but there are many factors affecting the curative effect. It is necessary to consider the clinical and pathological characteristics of patients in clinical treatment.
ABSTRACT
<p><b>OBJECTIVE</b>To set up the drug lymphocyte stimulation test (DLST), as a diagnosis means for DILI which was immunity idiosyncrasy, improve the Diagnosis, level of DILI.</p><p><b>METHOD</b>For the 59 patients who diagnosed as DILI, we separated their PBMC, exploring to the suspicious drug which caused DILI, then use the methods 3H-TdR to test, according to the mixed degree to clear the PBMC count which specific activated by drug.We also set up drug group, negative control and Positive control at the same time. Preliminary experiments was including the best dose of PHA and the best concentration of the drug. We set up 40 healthy group in our experiments as a control, and explore them on the same drug every time. We test the two groups at the same time. We handled the results use t-test.</p><p><b>RESULTS</b>The methods 3H-TdR could be exactly reflect the PBMC's proliferation degree nearly the same when they were be stimulation by PHA or the sensitive drug. When the DILI patients were explore to the suspicious drug, their stimulation index (SI) Obviously higher than 1.8. Form this test, there were 28 in 59 patients of DILI's group were positive (47.46%), SI was from 1.9 to 43.08, the average was 22.49, the healthy group SI was lower than 1.8, the SI of DILI's group was significantly higher than healthy group (5.78+/-0.75/1.16+/-0.25, P less than 0.05). Our test suggested DLST has Higher specificity (94.92%) and sensitivity (47.46%).</p><p><b>CONCLUSION</b>DLST was significance for the patients who diagnosed as immunity idiosyncrasy's DILI, it's reflected these patients' Proliferation of PBMC when explored to the suspicious drug for the second time.</p>