分泌性中耳炎患儿手术治疗前后炎性细胞因子的变化及其临床意义

发布时间：2018-10-30 18:29

【摘要】：目的探讨分泌性中耳炎(SOM)患儿手术治疗前后中耳积液和血浆中炎性细胞因子的变化,并分析其临床意义。方法选取我科2009—2011年收治的57例(93耳)SOM患儿(SOM组),均行鼓膜切开置管术治疗,术后常规应用抗生素和黏液促排剂。分别在手术治疗前后检测SOM患儿中耳积液和血浆中炎性细胞因子——肿瘤坏死因子α(TNF-α)、白介素2(IL-2)、白介素6(IL-6)、白介素10(IL-10)水平,并以我院2010—2011年员工的10例健康儿童血浆样本作为对照组。结果 (1)57例(93耳)患儿中,有51例(84耳)成功采集到中耳积液,其TNF-α、IL-2、IL-6、IL-10阳性率分别为84.5%(71/84)、78.6%(66/84)、86.9%(73/84)和82.1%(69/84)。(2)病程≤14 d的SOM患儿中耳积液中IL-2、IL-6水平均高于病程14 d的患儿(P0.05),病程与中耳积液中IL-2、IL-6水平呈负相关(r=-0.476,P0.05;r=-0.366,P0.05);而病程14 d的患儿中耳积液中TNF-α、IL-10水平均高于病程≤14 d的患儿(P0.05),病程与中耳积液中TNF-α、IL-10水平呈正相关(r=0.387,P0.05;r=0.484,P0.01)。(3)治疗前SOM组患儿中耳积液中TNF-α、IL-2、IL-6、IL-10水平均高于SOM组血浆、对照组血浆水平(P0.05),SOM组血浆IL-2、IL-6水平均高于对照组血浆水平(P0.05);有93%(53/57)的SOM患儿经鼓膜切开置管术治疗后中耳积液消失,听力恢复正常或改善;伴随着血浆上述4个炎性细胞因子水平的下降(P0.05)。结论炎性细胞因子在儿童SOM的发生、发展和预后中起重要作用,其表达水平随着病程的进展和手术治疗而变化,故炎性细胞因子可作为儿童SOM发病和治愈诊断的辅助指标。
[Abstract]:Objective to investigate the changes of inflammatory cytokines in middle ear effusion and plasma before and after operation in children with secretory otitis media (SOM). Methods 57 cases (93 ears) of SOM (SOM group) admitted in our department from 2009 to 2011 were treated with tympanic membrane incision and catheterization. The levels of inflammatory cytokines such as tumor necrosis factor 伪 (TNF- 伪), interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin 10 (IL-10) in middle ear effusion and plasma of children with SOM were detected before and after operation. The plasma samples of 10 healthy children in our hospital from 2010-2011 were used as control group. Results (1) among 57 cases (93 ears), 51 cases (84 ears) successfully collected middle ear effusion. The positive rates of TNF- 伪 and IL-2,IL-6,IL-10 were 84.5% (71 / 84) and 78.6% (66 / 84), respectively. 86.9% (73 / 84) and 82.1% (69 / 84). (_ 2) of SOM patients with duration 鈮，

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