药物预防耳蜗植入后内耳纤维化的研究

项目名称： 药物预防耳蜗植入后内耳纤维化的研究

项目编号： No.81200742

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 医学二处

项目作者： 贾欢

作者单位： 上海交通大学

项目金额： 23万元

中文摘要： 人工耳蜗植入后内耳纤维化是其最常见的病理改变，纤维化的形成不仅会增加电极电阻，直接影响人工耳蜗的性能；同时新生的纤维组织会破坏耳蜗内听觉细胞的固有结构，损伤残留听力，使目前最前沿的电声刺激技术的获益降低。因此，如何减少人工耳蜗植入后蜗内纤维化的形成，是近期的研究热点之一。近年来，柔手术或软电极等新技术、新材料已被应用，但术后纤维化现象仍然存在。因此，药物控制纤维化的研究就愈发显得重要。针对纤维化形成的机制，通常使用抗炎、抗有丝分裂、抗胶原合成药物来抑制纤维化。其中，激素类药物在耳科领域最常使用，但其抑制植入后蜗内纤维化的短期效果存在争议，长期效果不佳；而抗有丝分裂、抗胶原合成药物的蜗内应用报道较少。本项目拟通过研究抗炎、抗有丝分裂、抗胶原合成药物（地塞米松、去炎松、阿糖胞苷、常山酮）对内耳纤维化的抑制作用及毒副作用，总结出比现行方法更安全、更有效的植入后内耳纤维化的药物预防策略。

中文关键词： 内耳；耳蜗植入；纤维化；药物；治疗

英文摘要： Intracochlear fibrosis is the common pathologic change after cochlear implantation. The formation of fibrosis impacts not only the implant's performance by increasing the electrode impedances which result in the increases of the T-levels and C-levels, and the decrease of the dynamic range; it also influences the benefit of electric acoustic stimulation by destroying the structures of auditory cells which result in the hearing loss. Hence, how to reduce the formation of intracochlear fibrosis after implantation leads to a series of researches. Recently, the soft surgery, the soft or contour electrode have been clinically applied, but their outcomes were not ideal. Meanwhile, the intracochlear pharmacologic application, such as glucocorticoid, has been also studied, but the results also showed a controversial early outcome and an inefficient later outcome. Our project aims to reduce the intracochlear fibrosis via the pharmacologic agents, such as anti-inflammatory, anti-mitotic, or/and anti-collagen agents (dexamethasone, triamcinolone, cytarabine, halofuginone), and evaluate their anti-fibrotic effects and toxicities. Finally, this project tries to find out a safe and effective pharmacologic strategy to inhibit intracochlear fibrosis after cochlear implantation.

英文关键词： inner ear；cochlear implant；fibrosis；pharmacologic；treatment