目的 探討銀杏葉提取物注射液聯合氨磷汀治療放射性耳蝸損傷的臨床療效。方法 選取2014年5月-2017年5月在常州市第三人民醫(yī)院進行治療的放射性耳蝸損傷患者74例，根據用藥的差別分為對照組（37例）和治療組（37例）。對照組靜脈滴注注射用氨磷汀，200~300 mg/m²溶于生理鹽水50 mL中，持續(xù)15 min；治療組在對照組基礎上靜脈滴注銀杏葉提取物注射液，20 mL溶于5%葡萄糖溶液250 mL中，2次/d。兩組患者均經過2周治療。觀察兩組患者臨床療效，比較治療前后兩組患者氣導聽閾、骨導聽閾、中耳滲液氧化應激指標和血清細胞因子水平。結果 治療后，對照組臨床有效率為62.16%，顯著低于治療組的86.49%，兩組比較差異具有統計學意義（P<0.05）。治療后，兩組患者氣導聽閾、骨導聽閾值均顯著降低（P<0.05）；且治療組比對照組降低更明顯（P<0.05）。治療后，兩組患者中耳滲液中脂質過氧化物（LPO）、丙二醛（MDA）水平均明顯降低，超氧化物歧化酶（SOD）水平顯著升高，同組比較差異具有統計學意義（P<0.05）；且治療組上述指標改善后水平明顯優(yōu)于對照組（P<0.05）。治療后，兩組血漿內皮素（ET）、可溶性血管細胞間黏附分子-1（sVCAM-1）水平顯著降低，降鈣素基因相關肽（CGRP）水平顯著升高，同組比較差異具有統計學意義（P<0.05）；且治療組血清細胞因子水平明顯優(yōu)于對照組（P<0.05）。結論 銀杏葉提取物注射液聯合氨磷汀治療放射性耳蝸損傷可有效改善內耳循環(huán)和氧化應激水平，促進患者聽力恢復，具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of Extract of Ginkgo Biloba Leaves Injection combined with amifostine in treatment of radiation cochlear injury.Methods Patients (74 cases) with radiation cochlear injury in Changzhou Third People's Hospital from May 2014 to May 2017 were divided into control (37 cases) and treatment (37 cases) according to different treatments.Patients in the control group were iv administered with Amifostine for injection for 15 min,200-300 mg/m² added into normal saline 50 mL.Patients in the treatment group were iv administered with Extract of Ginkgo Biloba Leaves Injection on the basis of the control group,20 mL added into 5% glucose solution 250 mL,twice daily.Patients in two groups were treated for 2 weeks.After treatment,the clinical efficacy was evaluated,the air and bone conduction threshold,oxidative stress indexes of middle ear effusion and the serum cytokines in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control group was 62.16%,which was significantly lower than 86.49% in the treatment group,and there were differences between two groups (P<0.05).After treatment,the air and bone conduction threshold value in two groups was significantly decreased (P<0.05),and the value in the treatment group was significantly lower than that in the control group (P <0.05).After treatment,the LPO and MDA level in two groups was significantly decreased,but SOD level was significantly increased,and there were differences in the same group (P<0.05).And these oxidative stress indexes in the treatment group were significantly better than those in the control group (P<0.05).After treatment,the ET and sVCAM-1 level in two groups was significantly decreased,but CGRP level was significantly increased,and the difference was statistically significant in the same group (P<0.05).And these serum cytokines in the treatment group were significantly better than those in the control group (P<0.05).Conclusion Extract of Ginkgo Biloba Leaves Injection combined with amifostine in treatment of radiation cochlear injury can effectively improve the circulation and oxidative stress level of the inner ear,and promote the recovery of hearing,which has a certain clinical application value.

常州市衛(wèi)生局重大科技項目（ZD201414）