白细胞介素6和肿瘤坏死因子-α在分泌性中耳炎渗出液中表达及意义

Interleukin 6 and tumor necrosis factor alpha in middle ear effusions

为探讨细胞因子在分泌性中耳炎发生和转归中的作用，采用酶联免疫吸附试验法，对行鼓膜穿刺术的分泌性中耳炎患者中耳渗出液进行白细胞介素６（ＩＬ－６）和肿瘤坏死因子－α（ＴＮＦ－α）检测。结果示２２份中耳渗出液中ＩＬ－６阳性者为１９份（８６．３６％）；２７份中耳渗出液中ＴＮＦ－α阳性者为１９份（７０．３７％），平均浓度（ｘ±ｓ）分别为５０７．６８±８１３．１１ｎｇ／Ｌ和１８６．８６±１６６．９３ｎｇ／Ｌ。病程短者，ＩＬ－６浓度高（Ｐ＜０．０５）；病程长者，ＴＮＦ－α浓度高（Ｐ＜０．０５），提示ＩＬ－６在疾病早期参与了机体的防御反应；ＴＮＦ－α主要与疾病的持续状态相关，可引起过度炎症反应，导致损害效应。推测在分泌性中耳炎的发病过程中免疫机制可起重要作用。

Using enzyme linked immunosorbant assay ( ELISA), we measured levels of interleukin 6 (IL 6) and tumor necrosis factor alpha(TNF α) in middle ear effusions ( MEE) from patients with secretory otitis media (SOM) undergoing auripuncture to study the role of cytokines in the pathogenesis of the disease. Significant levels of IL 6 (>62.5 ng/L) were found in 19 (86.36%) of 22 MEEs and those of TNF α (>37.5ng/L) in 19 (70.37%) of 27 MEEs. The mean (± s ) levels of IL 6 and TNF α were 507.68±813.11 ng/L and 186.86±166.93 ng/L,respectively.It revealed that the shorter the course, the higher the concentration of IL 6 in MEE; the longer the course, the higher the conentration of TNF α in MEE. These findings suggested that during the early stages of SOM, IL 6 might participate in the defensive reaction of organism, while TNF α might be closely related to the persistence of SOM, resulting in an excessive inflammatory reaction with a potential for pathological changes. It is concluded that the immunological mechanisms probably play a significant role in the pathogenesis of SOM.