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目的:采用庆大霉素鼓室内注射,通过听觉电生理研究及电镜观察,研究豚鼠中耳局部应用庆大霉素的耳蜗毒性作用,以及刺五加有无对抗庆大霉素耳毒性作用。方法:选择健康豚鼠44只,随机分成3组:庆大霉素组、庆大霉素和刺五加组、生理盐水组。分别检测3组豚鼠ABR。鼓室内注射每天1次,连续7天:第1、2组注射3%庆大霉素,第3组注射生理盐水。第2组同时腹腔注射刺五加注射液,每天1次,连续14天。2周后检测3组ABR反应阈。处死,制备标本行电镜观察。结果:第1组ABR反应阈于给药前、后分别为20.63±6.55dbSpl、69.69±18.02dbSpl;第2组分别为18.75±5dbSpl、40.33±16.53dbSpl;第3组分别为19.17±4.69dbSPI、23.75±8.53dbSpl。单因素方差分析(ANOVA),给药前3组ABR反应阈差异(F=0.5,P>0.05)无统计学意义;给药前、后3组ABR反应阈差异(F=24.31,P<0.01)有统计学意义。给药前、后各组ABR反应阈之差(配对t检验),第1和第2组有统计学意义,第3组无统计学意义。给药前、后3组ABR反应阈之差两两比较(scheffe检验),第1组和第2组、第1组和第3组、第2组和第3组均有统计学意义。扫描电镜第1组,可见corti器外毛细胞纤毛稀疏、脱落及破坏,内毛细胞基本正常;第2组可见外行细胞纤毛倒伏、变形及模糊,内毛细胞正常;第3组可见耳蜗内、外行细胞均正常。透射电镜第1组可见corti器毛细胞核染色质固缩、凝聚,线粒体嵴断裂,空泡样变性;第2组毛细胞线粒体肿胀,嵴模糊,部分断裂;第3组毛细胞正常。结论:豚鼠鼓室内注射庆大霉素可以导致耳蜗corti器毛细胞破坏,ABR反应阈显著提高,具有明显的耳蜗毒性。联合应用中药刺五加组的豚鼠也出现了耳蜗corti器毛细胞破坏,ABR反应阈提高,但比单独应用庆大霉素组程度轻,表明刺五加具有对抗庆大霉素耳毒性作用。提示临床应禁用庆大霉素溶液滴耳,并可采用中药刺五加治疗药物性耳聋。
OBJECTIVE: To investigate the effects of gentamicin on cochlear toxicity of gentamicin in middle ear of guinea pig by electroacupuncture and electrophysiological study using gentamicin in the tympanic cavity, and whether or not acanthopanax senticosus against gentamicin ototoxicity. Methods: Forty-four healthy guinea pigs were randomly divided into 3 groups: gentamycin group, gentamicin and acanthopanax senticosus group, and saline group. Three groups of guinea pigs were tested for ABR. Intrathecal injection once a day for 7 days: groups 1 and 3 injected gentamicin 3%, group 3 saline injection. Group 2 at the same time peritoneal injection Acanthopanax injection, 1 day, for 14 days. After 2 weeks, three groups of ABR thresholds were detected. Sacrificed, the preparation of specimens under electron microscopy. Results: The ABR response threshold of group 1 was 20.63 ± 6.55dbSpl and 69.69 ± 18.02dbSpl before and after administration, respectively; 18.75 ± 5dbSpl and 40.33 ± 16.53dbSpl in group 2, 19.17 ± 4.69dbSPI in group 3, 23.75 ± 8.53 dbSpl. There was no significant difference in ABR threshold (F = 24.31, P <0.01) between the three groups before and after the administration of ANOVA (F = 0.5, P> 0.05) ) Was statistically significant. Before and after administration, the difference of ABR threshold (paired t test) between groups was statistically significant in group 1 and group 2, and group 3 was not statistically significant. Before and after administration, the ABR thresholds were compared between the two groups (scheffe test). The first group and the second group, the first group and the third group, the second group and the third group were statistically significant. Scanning electron microscope in the first group, we can see corti outside the hair cells ciliated sparse, shedding and destruction, the basic normal hair cells; the second group of peripheral ciliated cells can be seen lodging, deformation and blur, the normal hair cells; third group visible cochlear, Abnormal cells are normal. In the first group, the nuclear chromatin condensation, cohesion, mitochondrial cristae and vacuolar degeneration in the corti hair cells were observed in the first group. The hair cell mitochondria in the second group were swollen, the cristae were fuzzy and partially broken; the hair cells in the third group were normal. CONCLUSION: Gentamicin can induce the destruction of cochlear corti hair cells in guinea pigs, and significantly increase the ABR response threshold with obvious cochlear toxicity. Combination of Chinese acanthopanax senticosus guinea pigs also appeared cochlear corti hair cell damage, ABR response threshold increased, but compared with the gentamicin group alone, indicating that Acanthopanax have gentamicin ototoxicity. Tips should be banned gentamicin solution ear drops, and can be used medicine Acanthopanaxis drug-induced deafness.