目的 探讨长春西汀注射液联合注射用纤溶酶治疗突发性耳聋的临床疗效。方法 选取2017年2月—2018年8月上海市徐汇区中心医院收治的突发性耳聋患者124例作为研究对象，采用随机数表法将所有患者分为对照组和治疗组，每组各62例。对照组静脉滴注注射用纤溶酶，100 U加入到生理盐水100 mL中，30 min内滴完，1次/d。治疗组在对照组治疗的基础上滴注长春西汀注射液，20 mg加入到5%葡萄糖注射液500 mL中，1次/d。两组均连续治疗10 d。观察两组的临床疗效，比较两组的血液流变学指标、凝血功能指标、血小板相关指标、平均听阈。结果 治疗后，对照组和治疗组的总有效率分别为69.35%、85.48%，两组比较差异有统计学意义（P<0.05）。治疗后，两组全血高切黏度、全血低切黏度、血浆黏度和红细胞压积水平均明显下降，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组全血高切黏度、全血低切黏度、血浆黏度和红细胞压积水平明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组血浆纤维蛋白原（Fg）水平明显下降，而活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）明显延长，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组这些观察指标明显优于对照组（P<0.05），两组比较差异有统计学意义（P<0.05）。治疗后，两组血管性假血友病因子（VWF）、蛋白酶激活受体（PAR）、血小板α颗粒膜糖蛋白（CD62p）、血小板溶酶体膜糖蛋白（CD61）水平均明显下降（P<0.05），同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组VWF、PAR、CD62p、CD61明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组平均听阈明显下降，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗后治疗组平均听阈明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 长春西汀注射液联合注射用纤溶酶治疗突发性耳聋具有较好的临床疗效，能提高患者的听力水平，改善患者的血液高凝状态和微循环，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Vinpocetine Injection combined with Fibrinogenase for injection in treatment of sudden deafness. Methods Patients (124 cases) with sudden deafness in Shanghai Xuhui District Central Hospital from February 2017 to August 2018 were randomly divided into control and treatment groups, and each group had 62 cases. Patients in the control group were iv administered with Vinpocetine Injection, 100 U added into normal saline 100 mL, dropped in 30 minutes, once daily. Patients in the treatment group were iv administered with Fibrinogenase for injection on the basis of the control group, 20 mg added into 5% glucose solution 500 mL, once daily. Patients in two groups were treated for 10 d. After treatment, the clinical efficacies were evaluated, and hemorheology indexes, coagulation function indexes, platelet related indexes, and mean hearing threshold in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 69.35% and 85.48%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, and hematocrit in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And the hemorheology indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the levels of Fg in two groups were significantly decreased, but APTT, TT, and PT in two groups were significantly prolonged, and the difference was statistically significant in the same group (P< 0.05). And the coagulation function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P< 0.05). After treatment, VWF, PAR, CD62p, and CD61 in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And the platelet related indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the mean hearing thresholds in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And the mean hearing thresholds in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P< 0.05). Conclusion Vinpocetine Injection combined with Fibrinogenase for injection has clinical curative effect in treatment of sudden deafness, can improve the hearing level, blood hypercoagulability and microcirculation, which has a certain clinical application value.