军事噪声性耳聋与细胞能量代谢的功能研究

发布时间：2018-02-20 02:08

本文关键词： 军事噪声性耳聋细胞能量代谢活性氧线粒体　出处：《昆明医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的目前军事噪声性耳聋治疗多限于对症,仍待进一步研究阐明。本研究项目对2012年8月到2013年8月成都军区某部400余名军事噪声接触成年男性进行听力调查和测验,结合培养情况和听力差别情况从中筛选出3例军事噪声性耳聋易感患者和3例听力正常者为功能研究对象,分别从听力学检查、细胞活性氧测定、ATP功能测定等方面进行军事噪声性耳聋与细胞能量代谢的相关性研究,旨在探究是否可通过对细胞活性氧和ATP功能检测诊断或预测军事噪声性耳聋的发生可能,并为军事噪声性耳聋可能存在的遗传学缺陷提供实验基础证明。方法本研究按照研究纳入和排除标准收集了2012年8月到2013年8月成都军区某部队400余名噪声接触者的听力调查和测试资料,初步选出37例为研究对象并进行2次重复听力调查和测验,选出11例并进行下一步的永生化细胞系的建立。最终筛选出3例军事噪声性耳聋易感患者(WZD、TZY、ZL)为噪声易感组,3例噪声暴露更多而听力无明显减弱者(LQK、SJX、LAH)为耐受组,对其临床资料进行回顾性分析,并对军事噪声性耳聋与细胞能量代谢相关指标的关系进行相关性研究。结果1.耐受组和噪声易感组共6例样本,年龄分布21-27岁,平均年龄24岁,均为成年男性。噪声易感组病人均于发病2周后就诊,均为极重度耳聋。其中1例无耳鸣,2例有单侧耳鸣,呈持续高调音,平均疗程3个月,听力及耳鸣程度的改善甚微。本实验中噪声易感组听力损失程度均为极重度,听力曲线类型以陡降型为主,呈军事噪声性耳聋的特定的听力图形,听性脑干反应和声反射阈值均明显增高；耐受组听力损失程度为0级,听力曲线类型为平坦型,听性脑干反应和声反射无明显异常改变。两组人员的声导抗图鼓室图和影像学检查均未见异常。 2.噪声易感组和耐受组经细胞活性氧(DCFH-DA.Mitotracker red fm细胞荧光染色)、ATP浓度检测并使用Graphpad prism5.0软件作图示各样本之间无明显规律。两组之间归一化并取均值后：噪声易感组ROS水平、Mitotracker red fm荧光信号水平及ATP水平均低于耐受组,以上结果经统计示无明显差异。结论1.ROS的检测结果在军事噪声性耳聋与细胞能量变化的研究指标中不具特异性； 2.噪声易感组的Mitotracker red fm荧光信号水平和ATP水平均低于耐受组,符合文献理论结果,虽有差别趋势,但无明显统计学意义,而两组之间的听力学检测水平差异较大,故Mitotracker red fm荧光信号和ATP的水平检测在军事噪声性耳聋与细胞能量变化的研究中不具特异性或不是主要检测研究指标。
[Abstract]:Objective at present, the treatment of military noise-induced deafness is limited to symptoms, which still needs to be further studied and clarified. This study investigated and tested the hearing of more than 400 adult males exposed to military noise in a military region from August 2012 to August 2013. Three patients with military noise deafness and three normal hearing patients were selected from the culture and hearing differences as functional subjects, and were examined by audiology, respectively. In order to explore whether it is possible to diagnose or predict the occurrence of military noise-induced deafness through the detection of cellular reactive oxygen species and ATP function, the correlation between military noise-induced deafness and cell energy metabolism was studied in this paper. It also provides experimental evidence for possible genetic defects in military noise-induced deafness. Methods according to the criteria of inclusion and exclusion of the study, the data of hearing investigation and test of more than 400 noise exposed persons in a military unit of Chengdu military region from August 2012 to August 2013 were collected. 37 cases were selected as the subjects and 2 repeated hearing surveys and tests were conducted. 11 cases were selected and the next immortalized cell lines were established. Finally, 3 cases of military noise induced deafness were selected as the tolerance group, and 3 cases with more noise exposure but no obvious hearing loss were selected as the tolerance group. The clinical data were analyzed retrospectively and the correlation between military noise deafness and cell energy metabolism was studied. Results 1. Six patients in the tolerance group and the noise susceptible group, aged 21-27 years old with an average age of 24 years, were all adult males. All the patients in the noise-prone group were treated 2 weeks after the onset of the disease. 2. One case without tinnitus had unilateral tinnitus with continuous hypertonation, and the average course of treatment was 3 months, with little improvement in hearing and tinnitus degree. In this experiment, the degree of hearing loss was very severe in the noise-prone group. The type of hearing curve was steeply descending, showing a specific hearing pattern of military noise-induced deafness, auditory brainstem response and acoustic reflex threshold were significantly increased, the degree of hearing loss in tolerance group was 0, and the type of hearing curve was flat. There were no abnormal changes in auditory brainstem response and acoustic reflex. 2. The noise susceptible group and the tolerant group were detected by reactive oxygen species (Ros) DCFH-DA.Mitotracker red FM cell fluorescence staining, and the Graphpad prism5.0 software was used to show that there was no obvious regularity between the samples. After normalization and mean value between the two groups: noise susceptible group ROS. The fluorescence signal level and ATP level of Mitotracker red FM were lower than those of tolerance group. There was no statistical difference between the above results. Conclusion 1. The results of Ros are not specific in the study of the changes of cell energy and deafness caused by military noise. 2. The Mitotracker red FM fluorescence signal level and ATP level in noise-susceptible group were lower than those in tolerance group, which were consistent with the theoretical results of literature, although there was a trend of difference, but there was no significant difference between the two groups, and there was a great difference in audiological test level between the two groups. Therefore, the detection of Mitotracker red FM fluorescence signal and ATP level is not specific or the main detection index in the study of military noise induced deafness and cell energy change.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R764.433

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