分泌性中耳炎建模影响因素的实验研究

Experimental study on the factors affecting model of secretory otitsmedia

目的：为了研究分泌性中耳炎的发病机制及启动机制．方法：使用猫，采用阻塞咽鼓管、破坏咽鼓管通气机能及中耳局部注射内毒素等方法建立分泌性中耳炎模型，并检测中耳积液免疫复合物（ＩＣ）及内毒素．结果：发现单纯破坏咽鼓管通气机能、单纯应用内毒素仅有少数动物产生中耳积液，用弹性乳胶阻塞咽鼓管后，中耳积液明显增多，应用氢化考的松可以使中耳积液ＩＣ和积液量减少．抗菌素不能减少中耳积液量．中耳积液内毒素水平除应用内毒素组外，均和血浆内毒素无明显差别（Ｐ＞０．０５），中耳积液ＩＣ和血清ＩＣ除单纯破坏咽鼓管通气机能组外，均相差显著（Ｐ＜０．０１）．结论：ＩＣ沉积可能是启动因素；咽鼓管通气功能障碍并非分泌性中耳炎发病的必要条件；内毒素可能与病程有关．

Objective :We aim to investigate the pathogenesis and mechanism of secretory otitis media.Meth-ods :Secretory otitis media model with cats was established by using eustachian tube obstruction,damagingthe ventilatory function of eustachian tube and locally injecting endotoxin at middle ear,and detecting the lev-els of immunocomplex and endotoxin.Results:It was found that only few animals produced middle ear effu-sion by simply damaging the ventilatory function of eustachian tube or using endotoxin. Middle ear effusion increased obviouslv after the eustachian tube was obstructed by elastic emulsion.The use of hvdrocortisone could make middle ear effusion immunocomplex and effusion quantity decrease.Antibiotics couldn’t reduce middle ear effusion quantity.The endotoxin levels of middle ear effusion had no differences from that ofserum endotoxin(P> 0.05)except for in the group of simply damaging the ventilary function of eustachian tube(P<0.01 ).Conclusions :The results suggested that immunocomplex might be the starting factors,the ventilatation disturbance of eustachian tube isn’t the necessary pathogenic condition of secretory otitis midiaEndotoxin might be related to the course of the disease.