顺铂耳毒性的临床听力学研究

目的:应用0.5 kHz～16 kHz畸变产物耳声发射DPOAE和扩展高频测听对顺铂耳毒性进行临床研究.探讨顺铂耳毒性的听力学损害特点及其可能的发病机理.方法:对24例应用顺铂进行初次化疗的妇科肿瘤患者于化疗前后分别进行0.5 kHz～16.0 kHz DPOAE、常频纯音测听及扩展高频测听检查,比较DPOAE和常频纯音测听、扩展高频测听的结果.结果:顺铂化疗后扩展高频区纯音听阈升高,DPOAE在3.0kHz、4.0 kHz处及扩展高频区下降明显.19岁～29岁组变化明显,而50岁～65岁组无变化.结论:顺铂具有明确的耳毒性.常频DPOAE较常频纯音测听更敏感,和扩展高频测听检查一样均可用于顺铂耳毒性的监测.扩展高频DPOAE可能比常频DPOAE更敏感.患者对顺铂的易感性可能随着年龄的增加逐渐减低.

A Clinical Audiometric Study on Ototoxicity of Cisplatin

Objective:To investigate the ototoxicity of cisplatin on distortion product otoacoustic emissions(DPOAE)and high frequency audiometry. Methods:DPOAE,conventional pure tone audiometry and expanded high frequency audiometry were examined in 24 gynecologic cancer patients before and after the first time of cisplatin administration.DPOAE amplitudes,conventional pure tone hearing thresholds and expanded high frequency hearing thresholds were compared statisticaolly.Results:After cisplatin administration, the pure tone hearing thresholds at expanded high frequency area incseased significantly,DPOAE amplitudes at frequency from 3 to 4 kHz and expanded high frequency area declined significantly too.The obvious change occurred in group of age from 19 to 29.No auditory chauges were foumd in patients(50~65 years old).Conclusion:DPOAE is a potential implement to early detect dectection of the ototoxicity of cisplatin.The susceptibility to cisplatin maybe declined while patient's age have increased.