巴曲酶治疗全频下降型突发性耳聋的疗效观察及与凝血功能的相关性分析

目的 探讨巴曲酶治疗全频下降型突发性耳聋的疗效与巴曲酶敏感性及凝血功能指标的相关性。方法 回顾性分析2019年1月—2021年2月全频下降型突发性耳聋患者48例，根据患者纤维蛋白原(FIB)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)、FIB的变化及治疗前后纯音听阈变化。结果 ①48例患者总有效率为75.0%，其中平坦型总有效率为72.4%，全聋型总有效率为78.9%，敏感组有效率为85.7%，非敏感组有效率为60.0%，敏感组有效率高于非敏感组，差异具有统计学意义(P<0.05)；②敏感组患者治疗后与治疗前相比FIB、APTT下降,TT、PT升高，差异具有统计学意义(P<0.05)，非敏感组患者治疗后较治疗前FIB降低，TT升高，差异具有统计学意义(P<0.05)。治疗后，敏感组FIB低于非敏感组，TT、PT高于非敏感组，差异具有统计学意义(P<0.05)。结论 巴曲酶敏感性与临床治疗效果具有相关性，主要与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，使抗凝、纤溶和凝血在一定范围内保持平衡，安全性良好。

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

Objective 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.Methods A retrospective analysis was conducted on 48 patients with sudden deafness and full frequency decline from January 2019 to February 2021 in our hospital. According to the changes of fibrinogen, the patients were divided into sensitive group and non-sensitive group. It was detected for the coagulation function including activated partial thrombin 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 48 patients was 75.0%, including 72.4% for flat type, 78.9% for total deafness type, 85.71% for sensitive group and 60.0% for non-sensitive group. The effective rate of sensitive group was higher than that of non sensitive group, and the difference was statistically significant (P<0.05). (2) After treatment, FIB and APTT decreased and TT and PT increased in the sensitive group compared with before treatment, the difference was statistically significant (P<0.05);. After treatment, FIB decreased and TT increased in the non sensitive group compared with before treatment (P<0.05). After treatment, FIB in sensitive group was lower than that in non-sensitive group, TT and PT were higher than that in non sensitive group (P<0.05).Conclusions Batroxobin sensitivity is correlated with clinical therapeutic effect, which is mainly closely related to FIB, PT and TT, but not closely 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, so that the anticoagulant, fibrinolysis and coagulation in a certain range of balance, good safety.