目的 探讨巴曲酶首剂加倍治疗全频下降型突发性耳聋的疗效。 方法 选择2022年8月至2024年10月在贵州医科大学第二附属医院耳鼻咽喉科就诊的全频下降型突发性耳聋患者96例。按随机数字表法分为观察组和对照组，各48例。对照组给予银杏叶提取物、甲泼尼龙片、首次给药剂量10 BU巴曲酶治疗。观察组给予银杏叶提取物、甲泼尼龙片、首次给药剂量20 BU巴曲酶治疗。治疗1个周期后，比较两组的纯音听阈、血液流变学指标、凝血功能指标、疗效及不良反应。随访6个月，记录复发结局。 结果 治疗后，两组纯音听阈降低，观察组低于对照组（P < 0.05）。治疗后，观察组和对照组的治疗有效率分别为77.08%、54.17%，全血低切黏度分别为（18.27 ± 1.63）、（20.29 ± 1.41）mPa·s，全血中切黏度分别为（5.58 ± 0.64）、（6.01 ± 0.69）mPa·s，全血高切黏度分别为（4.26 ± 0.38）、（4.54 ± 0.31）mPa·s，血浆黏度分别为（1.52 ± 0.26）、（1.71 ± 0.34）mPa·s，红细胞聚集指数分别为（0.60 ± 0.21）、（0.52 ± 0.17），红细胞变形指数分别为（5.73 ± 0.61）、（6.20 ± 0.64），纤维蛋白原（FIB）分别为（0.72 ± 0.18）、（0.95 ± 0.13）g/L，凝血酶时间（TT）分别为（23.51 ± 2.08）、（21.76 ± 2.13）s，凝血酶原时间（PT）分别为（12.71 ± 0.63）、（12.05 ± 0.65）s，活化部分凝血酶原时间（APTT）分别为（28.32 ± 3.07）、（29.51 ± 2.24）s，以观察组更明显（P < 0.05）。观察组复发率低于对照组（P < 0.05）。 结论 巴曲酶首剂加倍治疗全频下降型突发性耳聋，有助于减轻患者的听力障碍症状，改善内耳微循环，提升治疗有效率。

Objective To explore the therapeutic effect of doubling the first dose of batroxobin in the treatment of sudden sensorineural hearing loss with reduced frequency. Methods A total of 96 patients diagnosed with sudden sensorineural hearing loss， who received treatment at the Department of Otolaryngology at the Second Affiliated Hospital of Guizhou Medical University between August 2022 and October 2024， were included in the study. Using the random number table method， the patients were assigned to two groups， an observation group and a control group， each comprising 48 cases. The control group was treated with Ginkgo biloba extract， methylprednisolone tablets， and a first dose of 10 BU of batroxobin， while the observation group was treated with Ginkgo biloba extract， methylprednisolone tablets， and a first dose of 20 BU of batroxobin. After one cycle of treatment， compare the pure tone hearing threshold， hemorheological indicators， coagulation function indicators， efficacy， and adverse reactions between the two groups. Follow up for 6 months and record the recurrence outcome. Results After treatment， the pure tone hearing threshold of both groups decreased， and the observation group was lower than the control group （P < 0.05）. After treatment， the effective rates of the observation group and the control group were 77.08% and 54.17%， respectively， and the whole blood low shear viscosity was （18.27 ± 1.63） （20.29 ± 1.41） mPa·s， the whole blood shear viscosity was （5.58 ± 0.64）， （6.01 ± 0.69） mPa·s， the whole blood high shear viscosity is （4.26 ± 0.38）， （4.54 ± 0.31） mPa·s， the plasma viscosity is （1.52 ± 0.26）， （1.71 ± 0.34） mPa·s， the red blood cell aggregation index is （0.60 ± 0.21）， （0.52 ± 0.17）， the red blood cell deformation index was （5.73 ± 0.61）， （6.20 ± 0.64）， and the fibrinogen （FIB） is （0.72 ± 0.18）. 0.95 ± 0.13） g/L， thrombin time （TT） were （23.51 ± 2.08） and （21.76 ± 2.13） s， prothrombin time （PT） were （12.71 ± 0.63） and （12.05 ± 0.65） s， respectively， and activated partial thromboplastin time （APTT） were （28.32 ± 3.07） and （29.51 ± 2.24） s， respectively， with the observation group showing more significant changes （P < 0.05）. The recurrence rate of the observation group was lower than that of the control group （P < 0.05）. Conclusion Doubling the first dose of batroxobin can help alleviate the symptoms of hearing impairment， improve inner ear microcirculation， and enhance treatment efficacy in patients with total frequency decline type sudden deafness.