本文關(guān)鍵詞： 軍事噪聲性耳聾 細(xì)胞 能量代謝 活性氧 線粒體　出處：《昆明醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的目前軍事噪聲性耳聾治療多限于對癥,仍待進(jìn)一步研究闡明。本研究項目對2012年8月到2013年8月成都軍區(qū)某部400余名軍事噪聲接觸成年男性進(jìn)行聽力調(diào)查和測驗,結(jié)合培養(yǎng)情況和聽力差別情況從中篩選出3例軍事噪聲性耳聾易感患者和3例聽力正常者為功能研究對象,分別從聽力學(xué)檢查、細(xì)胞活性氧測定、ATP功能測定等方面進(jìn)行軍事噪聲性耳聾與細(xì)胞能量代謝的相關(guān)性研究,旨在探究是否可通過對細(xì)胞活性氧和ATP功能檢測診斷或預(yù)測軍事噪聲性耳聾的發(fā)生可能,并為軍事噪聲性耳聾可能存在的遺傳學(xué)缺陷提供實驗基礎(chǔ)證明。 方法本研究按照研究納入和排除標(biāo)準(zhǔn)收集了2012年8月到2013年8月成都軍區(qū)某部隊400余名噪聲接觸者的聽力調(diào)查和測試資料,初步選出37例為研究對象并進(jìn)行2次重復(fù)聽力調(diào)查和測驗,選出11例并進(jìn)行下一步的永生化細(xì)胞系的建立。最終篩選出3例軍事噪聲性耳聾易感患者(WZD、TZY、ZL)為噪聲易感組,3例噪聲暴露更多而聽力無明顯減弱者(LQK、SJX、LAH)為耐受組,對其臨床資料進(jìn)行回顧性分析,并對軍事噪聲性耳聾與細(xì)胞能量代謝相關(guān)指標(biāo)的關(guān)系進(jìn)行相關(guān)性研究。 結(jié)果1.耐受組和噪聲易感組共6例樣本,年齡分布21-27歲,平均年齡24歲,均為成年男性。噪聲易感組病人均于發(fā)病2周后就診,均為極重度耳聾。其中1例無耳鳴,2例有單側(cè)耳鳴,呈持續(xù)高調(diào)音,平均療程3個月,聽力及耳鳴程度的改善甚微。本實驗中噪聲易感組聽力損失程度均為極重度,聽力曲線類型以陡降型為主,呈軍事噪聲性耳聾的特定的聽力圖形,聽性腦干反應(yīng)和聲反射閾值均明顯增高；耐受組聽力損失程度為0級,聽力曲線類型為平坦型,聽性腦干反應(yīng)和聲反射無明顯異常改變。兩組人員的聲導(dǎo)抗圖鼓室圖和影像學(xué)檢查均未見異常。 2.噪聲易感組和耐受組經(jīng)細(xì)胞活性氧(DCFH-DA.Mitotracker red fm細(xì)胞熒光染色)、ATP濃度檢測并使用Graphpad prism5.0軟件作圖示各樣本之間無明顯規(guī)律。兩組之間歸一化并取均值后：噪聲易感組ROS水平、Mitotracker red fm熒光信號水平及ATP水平均低于耐受組,以上結(jié)果經(jīng)統(tǒng)計示無明顯差異。 結(jié)論1.ROS的檢測結(jié)果在軍事噪聲性耳聾與細(xì)胞能量變化的研究指標(biāo)中不具特異性； 2.噪聲易感組的Mitotracker red fm熒光信號水平和ATP水平均低于耐受組,符合文獻(xiàn)理論結(jié)果,雖有差別趨勢,但無明顯統(tǒng)計學(xué)意義,而兩組之間的聽力學(xué)檢測水平差異較大,故Mitotracker red fm熒光信號和ATP的水平檢測在軍事噪聲性耳聾與細(xì)胞能量變化的研究中不具特異性或不是主要檢測研究指標(biāo)。
[Abstract]:Objective at present, the treatment of military noise-induced deafness is limited to symptoms, which still needs to be further studied and clarified. This study investigated and tested the hearing of more than 400 adult males exposed to military noise in a military region from August 2012 to August 2013. Three patients with military noise deafness and three normal hearing patients were selected from the culture and hearing differences as functional subjects, and were examined by audiology, respectively. In order to explore whether it is possible to diagnose or predict the occurrence of military noise-induced deafness through the detection of cellular reactive oxygen species and ATP function, the correlation between military noise-induced deafness and cell energy metabolism was studied in this paper. It also provides experimental evidence for possible genetic defects in military noise-induced deafness. Methods according to the criteria of inclusion and exclusion of the study, the data of hearing investigation and test of more than 400 noise exposed persons in a military unit of Chengdu military region from August 2012 to August 2013 were collected. 37 cases were selected as the subjects and 2 repeated hearing surveys and tests were conducted. 11 cases were selected and the next immortalized cell lines were established. Finally, 3 cases of military noise induced deafness were selected as the tolerance group, and 3 cases with more noise exposure but no obvious hearing loss were selected as the tolerance group. The clinical data were analyzed retrospectively and the correlation between military noise deafness and cell energy metabolism was studied. Results 1. Six patients in the tolerance group and the noise susceptible group, aged 21-27 years old with an average age of 24 years, were all adult males. All the patients in the noise-prone group were treated 2 weeks after the onset of the disease. 2. One case without tinnitus had unilateral tinnitus with continuous hypertonation, and the average course of treatment was 3 months, with little improvement in hearing and tinnitus degree. In this experiment, the degree of hearing loss was very severe in the noise-prone group. The type of hearing curve was steeply descending, showing a specific hearing pattern of military noise-induced deafness, auditory brainstem response and acoustic reflex threshold were significantly increased, the degree of hearing loss in tolerance group was 0, and the type of hearing curve was flat. There were no abnormal changes in auditory brainstem response and acoustic reflex. 2. The noise susceptible group and the tolerant group were detected by reactive oxygen species (Ros) DCFH-DA.Mitotracker red FM cell fluorescence staining, and the Graphpad prism5.0 software was used to show that there was no obvious regularity between the samples. After normalization and mean value between the two groups: noise susceptible group ROS. The fluorescence signal level and ATP level of Mitotracker red FM were lower than those of tolerance group. There was no statistical difference between the above results. Conclusion 1. The results of Ros are not specific in the study of the changes of cell energy and deafness caused by military noise. 2. The Mitotracker red FM fluorescence signal level and ATP level in noise-susceptible group were lower than those in tolerance group, which were consistent with the theoretical results of literature, although there was a trend of difference, but there was no significant difference between the two groups, and there was a great difference in audiological test level between the two groups. Therefore, the detection of Mitotracker red FM fluorescence signal and ATP level is not specific or the main detection index in the study of military noise induced deafness and cell energy change.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R764.433

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