目的 探讨银杏叶提取物注射液联合氨磷汀治疗放射性耳蜗损伤的临床疗效。方法 选取2014年5月-2017年5月在常州市第三人民医院进行治疗的放射性耳蜗损伤患者74例，根据用药的差别分为对照组（37例）和治疗组（37例）。对照组静脉滴注注射用氨磷汀，200~300 mg/m²溶于生理盐水50 mL中，持续15 min；治疗组在对照组基础上静脉滴注银杏叶提取物注射液，20 mL溶于5%葡萄糖溶液250 mL中，2次/d。两组患者均经过2周治疗。观察两组患者临床疗效，比较治疗前后两组患者气导听阈、骨导听阈、中耳渗液氧化应激指标和血清细胞因子水平。结果 治疗后，对照组临床有效率为62.16%，显著低于治疗组的86.49%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者气导听阈、骨导听阈值均显著降低（P<0.05）；且治疗组比对照组降低更明显（P<0.05）。治疗后，两组患者中耳渗液中脂质过氧化物（LPO）、丙二醛（MDA）水平均明显降低，超氧化物歧化酶（SOD）水平显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗组上述指标改善后水平明显优于对照组（P<0.05）。治疗后，两组血浆内皮素（ET）、可溶性血管细胞间黏附分子-1（sVCAM-1）水平显著降低，降钙素基因相关肽（CGRP）水平显著升高，同组比较差异具有统计学意义（P<0.05）；且治疗组血清细胞因子水平明显优于对照组（P<0.05）。结论 银杏叶提取物注射液联合氨磷汀治疗放射性耳蜗损伤可有效改善内耳循环和氧化应激水平，促进患者听力恢复，具有一定的临床推广应用价值。

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.

常州市卫生局重大科技项目（ZD201414）