【摘要】： 目的探討地塞米松和西比靈對(duì)慶大霉素耳毒性的保護(hù)作用。 方法40只豚鼠隨機(jī)分為5組,慶大霉素組(G組)每日肌注慶大霉素150mg/kg,腹部皮下注射生理鹽水0.5m1。保護(hù)組：DF組每日肌注慶大霉素150mg/kg,腹部皮下注射地塞米松3mg/kg,西比靈3mg/kg灌胃；D組每日肌注慶大霉素150mg/kg,腹部皮下注射地塞米松3mg/kg,F組每日肌注慶大霉素150mg/kg,西比靈3mg/kg灌胃。對(duì)照組每日肌注生理鹽水3ml/kg,腹部皮下注射生理鹽水0.5ml；每組均連續(xù)用藥14天。每組動(dòng)物用藥前1天行聽(tīng)性腦干反應(yīng)(ABR)檢查,停藥后1天行聽(tīng)性腦干反應(yīng)(ABR)檢查和耳蝸基底膜組織學(xué)觀察,比較各組間ABR各波潛伏期及波間期、蘇木素染色后毛細(xì)胞形態(tài)、TUNEL染色凋亡陽(yáng)性毛細(xì)胞計(jì)數(shù)。 結(jié)果①用藥前各組動(dòng)物ABR波間期及潛伏期差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。停藥后慶大霉素組和保護(hù)組的各波潛伏期和波間期均較對(duì)照組延長(zhǎng)(P0.05),保護(hù)組中除D組外,DF組和F組各波潛伏期和波間期時(shí)間較慶大霉素組短,而且DF組的時(shí)間又較F組短(P0.05)。②耳蝸基底膜蘇木素染色觀察：慶大霉素組和D組外毛細(xì)胞排列紊亂,大量缺失；保護(hù)組中DF組和F組外毛細(xì)胞排列不規(guī)則,少量細(xì)胞缺失；對(duì)照組耳蝸外毛細(xì)胞排列整齊,無(wú)細(xì)胞缺失。③耳蝸基底膜TUNEL染色凋亡陽(yáng)性毛細(xì)胞計(jì)數(shù)：慶大霉素組和保護(hù)組較對(duì)照組明顯增多,而保護(hù)組中DF組和F組凋亡細(xì)胞數(shù)較慶大霉素組和D組少(P0.05)。 結(jié)論慶大霉素具有耳毒性,可導(dǎo)致豚鼠耳蝸毛細(xì)胞凋亡；西比靈或西比靈和地塞米松聯(lián)合用藥可減少慶大霉素誘導(dǎo)的耳蝸毛細(xì)胞凋亡,對(duì)聽(tīng)力有保護(hù)作用,聯(lián)合用藥效果優(yōu)于單藥應(yīng)用；單獨(dú)使用小劑量地塞米松對(duì)慶大霉素耳毒性沒(méi)有保護(hù)作用。
[Abstract]:Objective to investigate the protective effects of dexamethasone and sibiline on gentamicin ototoxicity. Methods Forty guinea pigs were randomly divided into 5 groups. Gentamycin group (G group) was intramuscularly injected with gentamicin 150 mg / kg daily, and normal saline 0.5 mg / kg was injected subcutaneously into abdomen. In the protection group, gentamicin was injected intramuscularly (150 mg / kg), dexamethasone was injected subcutaneously into the abdomen (3 mg / kg), the group D was given gentamicin 150 mg / kg by intramuscular injection, and the control group was subcutaneously injected with dexamethasone 3 mg / kg / kg F by intramuscular injection of gentamicin 150 mg / kg per day and siberelin 3mg/kg by intragastric perfusion. The control group was intramuscularly injected with saline (3 ml / kg) and subcutaneously injected with saline (0.5 ml) in each group for 14 days. The auditory brainstem response (ABR) was examined one day before treatment in each group, and the auditory brainstem response (ABR) and cochlear basement membrane histology were observed on the 1st day after withdrawal. The latencies and interwave periods of ABR waves were compared between each group. After hematoxylin staining, the number of apoptosis-positive hair cells was detected by Tunel staining. Results 1 there was no significant difference in ABR wave interval and latency before treatment (P0.05). The latencies and intervals of each wave in gentamicin group and protection group were longer than those in control group (P0.05). The latency and time of wave interval in DF group and F group were shorter than those in gentamicin group except D group (P0.05). Moreover, the time of hair cells in DF group was shorter than that in F group (P0.05). 2. Observation of hematoxylin staining on basal membrane of cochlea: the outer hair cells in gentamicin group and D group were disordered and a large number of hair cells were absent, while in DF group and F group, the arrangement of outer hair cells in DF group and F group was irregular and a few cells were absent. In the control group, the outer hair cells of the cochlea were arranged neatly, and the number of apoptosis-positive hair cells in the basal membrane of the cochlea without cell deletion was significantly increased in the gentamicin group and the protective group compared with the control group. The number of apoptotic cells in DF group and F group was lower than that in gentamicin group and D group (P0.05). Conclusion Gentamycin has ototoxicity and can induce apoptosis of cochlear hair cells in guinea pigs, sibelium or cibezole combined with dexamethasone can reduce the apoptosis of cochlear hair cells induced by gentamicin, and has protective effect on hearing. Low dose dexamethasone alone had no protective effect on gentamicin ototoxicity.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R764.5

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