【摘要】：目的探討分泌性中耳炎(SOM)患兒手術(shù)治療前后中耳積液和血漿中炎性細(xì)胞因子的變化,并分析其臨床意義。方法選取我科2009—2011年收治的57例(93耳)SOM患兒(SOM組),均行鼓膜切開置管術(shù)治療,術(shù)后常規(guī)應(yīng)用抗生素和黏液促排劑。分別在手術(shù)治療前后檢測(cè)SOM患兒中耳積液和血漿中炎性細(xì)胞因子——腫瘤壞死因子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年員工的10例健康兒童血漿樣本作為對(duì)照組。結(jié)果 (1)57例(93耳)患兒中,有51例(84耳)成功采集到中耳積液,其TNF-α、IL-2、IL-6、IL-10陽性率分別為84.5%(71/84)、78.6%(66/84)、86.9%(73/84)和82.1%(69/84)。(2)病程≤14 d的SOM患兒中耳積液中IL-2、IL-6水平均高于病程14 d的患兒(P0.05),病程與中耳積液中IL-2、IL-6水平呈負(fù)相關(guān)(r=-0.476,P0.05;r=-0.366,P0.05);而病程14 d的患兒中耳積液中TNF-α、IL-10水平均高于病程≤14 d的患兒(P0.05),病程與中耳積液中TNF-α、IL-10水平呈正相關(guān)(r=0.387,P0.05;r=0.484,P0.01)。(3)治療前SOM組患兒中耳積液中TNF-α、IL-2、IL-6、IL-10水平均高于SOM組血漿、對(duì)照組血漿水平(P0.05),SOM組血漿IL-2、IL-6水平均高于對(duì)照組血漿水平(P0.05);有93%(53/57)的SOM患兒經(jīng)鼓膜切開置管術(shù)治療后中耳積液消失,聽力恢復(fù)正�；蚋纳�;伴隨著血漿上述4個(gè)炎性細(xì)胞因子水平的下降(P0.05)。結(jié)論炎性細(xì)胞因子在兒童SOM的發(fā)生、發(fā)展和預(yù)后中起重要作用,其表達(dá)水平隨著病程的進(jìn)展和手術(shù)治療而變化,故炎性細(xì)胞因子可作為兒童SOM發(fā)病和治愈診斷的輔助指標(biāo)。
[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 偽 (TNF- 偽), 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- 偽 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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