噪声性耳聋的氧化还原药物保护作用研究进展

摘要

Noise Induced Hearing Loss (NIHL) is mostly caused by prolonged exposure to noise stimuli, which result in damage of the inner ear and gradual hearing loss, but a short duration of intense explosion or noise can also cause NIHL. In the case of short-time exposure and mild hearing damage, hearing may gradually recover after leaving the noisy environ-ment. However, injury caused by long-term exposure usually does not recover and can lead to permanent sensorineural hear-ing loss. The pathogenesis of NIHL remain controversial, but theories involving metabolic disorders following mechanic damage are widely accepted. Pathways of metabolic damage include (1) oxidative stress (2) calcium overload (3) cochlear tissue ischemia-reperfusion and (4) excitatory glutamate toxicity. Scientists speculate that preventing and intervening in these processes may help avoid or reduce hearing loss. Therefore, how to prevent and treat NIHL has become a hotspot in the field of otology research. In this review, we focus on the development in the study of protective effects of redox agents on NIHL to provide experimental and theoretical evidence for further research in clinical prevention and treatment of NIHL.%噪声性耳聋（Noise-induced Hearing Loss,NIHL）多是长时间接受噪声刺激而引起内耳进行性的、缓慢的听觉丧失或短期内遭受强烈爆震或声音后所引起的损害。接触噪声环境时间较短、损伤程度轻微者，尽早离开噪声环境,听觉有可能会逐渐恢复；若时间较长、损伤较重者，则很难恢复，甚至导致感音神经性聋。而NIHL的发病机制目前仍尚未完全阐明，但公认的噪声性耳聋致病机制首先发生机械性损伤，其次是代谢性损伤，而在代谢性损伤中又包括以下几点：①氧化应激学说②钙离子超载学说③耳蜗组织缺血再灌注学说④谷氨酸兴奋性毒性学说。因此，通过阻止或抑制以上各途径，推测可起到保护噪声性耳聋的作用，而在目前如何预防和治疗NIHL问题已成为各国耳科学者研究的重要课题。本文对NIHL在发病机制上的氧化还原药物保护作用研究进展进行综述，为今后临床上NIHL的预防和治疗提供进一步的实验和理论依据。