發(fā)布時間：2018-11-19 19:37

【摘要】： 目的：檢測TLR4在兒童肥大的腺樣體組織中的表達情況及IL-12在腺樣體組織和鼓室積液中的含量,探討腺樣體免疫功能異常在分泌性中耳炎發(fā)病機制中的作用。 方法：收集單純腺樣體肥大及伴有分泌性中耳炎的肥大腺樣體標本各15例,同時收集單純分泌性中耳炎及伴有腺樣體肥大的鼓室積液標本各15例。應用逆轉錄聚合酶鏈反應(RT-PCR)技術檢測TLR4在肥大腺樣體中的表達情況,應用ELISA法測定鼓室積液及肥大腺樣體組織中IL-12的含量。對各組間TLR4表達和IL-12含量的差異進行對比研究。 結果：所有肥大腺樣體組織中均有TLR4表達,個體之間差異較大。伴有分泌性中耳炎的肥大腺樣體組織中TLR4 mRNA表達水平高于單純腺樣體肥大組(P0.05)；重度腺樣體肥大者TLR4 mRNA表達水平顯著高于與中度腺樣體肥大組(P0.05)。伴有腺樣體肥大的分泌性中耳炎組鼓室積液中IL-12含量低于單純分泌性中耳炎組(P0.05),其腺樣體組織中IL-12含量顯著則高于單純腺樣體肥大組(P0.05)。腺樣體肥大合并分泌性中耳炎者其腺樣體組織中TLR4表達水平與IL-12含量呈正相關(r=0.901,P0.05)。 結論：合并分泌性中耳炎和增殖程度較重的腺樣體組織中TLR4表達增強；伴有腺樣體肥大的分泌性中耳炎患兒鼓室積液中IL-12含量較單純分泌性中耳炎者降低,合并分泌性中耳炎者腺樣體組織勻漿中IL-12的含量較單純腺樣體肥大者增高；在合并分泌性中耳炎的腺樣體肥大患者的腺樣體組織中,TLR4的表達水平與IL-12的含量呈顯著相關性。結果提示,TLR4介導的免疫反應可能通過調節(jié)鼻咽部和鼓室局部IL-12的含量在腺樣體肥大導致分泌性中耳炎的發(fā)病機制中起作用。
[Abstract]:Aim: to investigate the expression of TLR4 in children's hypertrophic adenoid tissues and the content of IL-12 in adenoid tissue and tympanic effusion, and to explore the role of adenoid immune dysfunction in the pathogenesis of secretory otitis media. Methods: 15 cases of adenoid hypertrophy and 15 cases of hypertrophic adenoid with secretory otitis media, 15 cases of simple secretory otitis media and 15 cases of tympanic effusion with adenoid hypertrophy were collected. The expression of TLR4 in hypertrophic adenoids was detected by reverse transcriptase polymerase chain reaction (RT-PCR) and the content of IL-12 in tympanic effusion and hypertrophic adenoid tissue was determined by ELISA method. The expression of TLR4 and the content of IL-12 in each group were compared. Results: the expression of TLR4 was found in all hypertrophic adenoid tissues. The expression of TLR4 mRNA in hypertrophic adenoid tissue with secretory otitis media was higher than that in simple adenoid hypertrophy group (P0.05), and the TLR4 mRNA expression level in severe adenoid hypertrophy group was significantly higher than that in moderate adenoid hypertrophy group (P0.05). The content of IL-12 in tympanic effusion of secretory otitis media with adenoid hypertrophy was lower than that in simple secretory otitis media (P0.05), and the content of IL-12 in adenoid tissue was significantly higher than that in simple adenoid hypertrophy (P0.05). The expression of TLR4 in adenoid tissue was positively correlated with the content of IL-12 in adenoid hypertrophy complicated with secretory otitis media (P 0.05). Conclusion: the expression of TLR4 was increased in adenoids with secretory otitis media and proliferation. The content of IL-12 in tympanic effusion of children with secretory otitis media with adenoid hypertrophy was lower than that of patients with simple secretory otitis media. The content of IL-12 in adenoid tissue homogenate of patients with secretory otitis media was higher than that of patients with simple adenoid hypertrophy. There was a significant correlation between the expression of TLR4 and the content of IL-12 in adenoid hypertrophy patients with secretory otitis media. The results suggest that TLR4 mediated immune response may play a role in the pathogenesis of secretory otitis media caused by adenoid hypertrophy by regulating the content of IL-12 in nasopharynx and tympanum.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R764

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