Objective: To analyze the correlation between the changes of fibrinogen and the treatment effect of all-frequency sudden deafness, and to explore the individualized treatment strategy for the use of Batroxobin. Methods: Patients with all-frequency sudden deafness who were admitted to Department of Otorhinolaryngology, People's Hospital of Peking University, from January 2010 to September 2016 were selected. All patients were given standard treatment and regular use of Batroxobin. Value of fibrinogen on D1 (before treatment) / D3 / D7 (±1) and D14 (±2) were recorded, at the same time, the correlation between the changes of fibrinogen and prognosis of all-frequency sudden deafness by the audiograms of onset and after-treatment of all patients were analyzed. Independent t-test was used to analyze normal distributed measurement data and chi square linear trend test was used to analyze the curative effect of different fibrinogen groups. Results: A total of 148 patients were included, the outcomes were worst when the patient's fibrinogen was below 2 g/L or above 4 g/L before treatment, ineffective rate were both 50%. The fibrinogen was lowest when the treatment came to the third day. Normally, the patient's prognosis was best when this value waved between 0.7 and 0.9 g/L, with a total effective rate between 73.9% and 83.3%. The fibrinogen value of the 7th day was a good indicator of the outcome, and Fib7 value was significant lower in patients of effective group than ineffective ones ((1.25±0.37)g/L vs (1.38±0.35) g/L, t=-0.27, P=0.04). Patients found a best recovery when Fib7 was below 1 g/L, and the higher the Fib7 value, the higher the inefficiency (χ(2)=7.55, P=0.01). Batroxobin showed safety during the treatment and found no complications. Conclusion: The change of fibrinogen in the process of all-frequency sudden deafness is closely related to the curative effect.
目的： 通过分析全频下降型突发性聋患者治疗期间纤维蛋白原的变化与疗效的相关性，探讨巴曲酶个性化用药的可行性。 方法： 选取2010年1月至2016年9月于北京大学人民医院耳鼻咽喉科住院治疗的全频下降型突发性聋患者共148例进行回顾性研究，所有患者均接受标准治疗方案且规律使用巴曲酶，监测其治疗第1天(用药前)、第3天、第(7±1)天及第(14±2)天的外周血纤维蛋白原，同时收集患者治疗前、第(14±2)天的纯音测听，分析纤维蛋白原值的变化与疗效的相关性。 结果： 治疗前患者的纤维蛋白原<2 g/L或>4 g/L时，其疗效较差。治疗第3天时，纤维蛋白原为最低值，其波动于0.7～0.9 g/L时疗效最好。治疗第(7±1)天时的纤维蛋白原对疗效有预测价值，其<1 g/L时疗效最好。治疗第(14±2)天时，纤维蛋白原整体较高。整个治疗过程中，巴曲酶安全性较好，无鼻腔、口腔、消化道出血或全身出血倾向。 结论： 全频下降型突发性聋患者治疗过程中纤维蛋白原的变化与疗效密切相关。.
Keywords: Fibrinogen; Hearing loss, sudden; Treatment outcome.