地塞米松联合盐酸氨溴索鼓室内注射治疗分泌性中耳炎的临床效果及其机制

发布时间：2018-11-27 10:47

【摘要】：目的观察地塞米松联合盐酸氨溴索鼓室内注射治疗分泌性中耳炎的临床效果,并探讨其可能的机制。方法将单耳分泌性中耳炎患者86例随机分为观察组和对照组,每组43例。观察组给予鼓室内注射地塞米松~+盐酸氨溴索,对照组仅在鼓室内注射地塞米松,1次/周,均连续注射4周。评价两组治疗效果,统计不良反应;检测治疗前后语频气导听阈、鼓室压;采用ELISA法检测两组治疗前后血清及中耳积液IL-5、IL-1β、IL-8及TNF-α,双抗体夹心免疫发光法检测降钙素原(PCT);采用流式细胞仪检测治疗前后外周血T淋巴细胞CD4~+、CD8~+百分比,计算CD4~+/CD8~+。结果观察组治疗有效率(90.70%)较对照组(74.42%)升高(P0.05)。治疗期间两组均未出现明显血常规异常、心电图异常等不良反应。两组治疗后语频气导听阈、鼓室压均较治疗前明显升高,且观察组变化更显著;血清及中耳积液IL-5、IL-1β、IL-8、TNF-α、PCT水平均较治疗前降低,且观察组IL-1β、IL-8、TNF-α、PCT水平均低于对照组;CD4~+百分比、CD4~+/CD8~+均较治疗前升高,CD8~+百分比均较治疗前降低,且观察组CD4~+百分比、CD4~+/CD8~+高于对照组;上述指标组间及组内比较P均0.05。结论地塞米松联合盐酸氨溴索鼓室内注射治疗分泌性中耳炎的效果优于单用地塞米松,其机制可能与改善免疫失调、减轻炎症反应有关。
[Abstract]:Objective to observe the clinical effect of dexamethasone combined with intratympanic injection of ambroxol hydrochloride in the treatment of secretory otitis media and explore its possible mechanism. Methods Eighty-six patients with monaural secretory otitis media were randomly divided into observation group (n = 43) and control group (n = 43). In the observation group, dexamethasone ~ ambroxol hydrochloride was injected into the tympanic chamber, while in the control group, dexamethasone was injected only once a week for 4 weeks. To evaluate the therapeutic effect of the two groups, to count the adverse reactions, to detect the hearing threshold and tympanic pressure of the two groups before and after the treatment. IL-5,IL-1 尾, IL-8 and TNF- 伪 in serum and middle ear effusion before and after treatment were detected by ELISA, and procalcitonin (PCT); was detected by double antibody sandwich immunoluminescence. The percentages of CD4~ and CD8~ in peripheral blood T lymphocytes before and after treatment were measured by flow cytometry and CD4~ / CD8~ were calculated. Results the effective rate of treatment in the observation group (90.70%) was higher than that in the control group (74.42%) (P0.05). During the treatment, there were no obvious abnormal blood routine, abnormal electrocardiogram and other adverse reactions. After treatment, the hearing threshold and tympanic pressure of the two groups were significantly higher than those before treatment, and the changes in the observation group were more significant. The levels of IL-5,IL-1 尾, IL-8,TNF- 伪 and PCT in serum and middle ear effusion were lower than those before treatment, and the levels of IL-1 尾, IL-8,TNF- 伪 and PCT in the observation group were lower than those in the control group. The percentage of CD4~, CD4~ / CD8~ and CD8~ decreased, and the percentage of CD4~ and CD4~ / CD8~ in the observation group was higher than that in the control group (P < 0.05). Conclusion Dexamethasone combined with intratympanic injection of ambroxol hydrochloride is superior to dexamethasone in the treatment of secretory otitis media.
【作者单位】：西宁市第一人民医院;
【分类号】：R764.21

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