内毒素含量与分泌性中耳炎复发关系的研究

Relationship between endotoxin content and the recurrence of secretory otitis media

目的 探讨中耳积液中的内毒素含量与分泌性中耳炎 (SOM)复发的关系。方法 用鲎珠溶解物凝胶反应法对 66名SOM患者共 88份中耳积液进行内毒素含量的动态检测。结果 内毒素检测阳性率和浓度在小于 14岁组的SOM患者 (分别为 77.2 %和 4 0 2±2 2 .2 4EU/ml)明显高于大于 15岁组SOM患者 (分别为 18.9%和 2 3± 5.98EU/ml) ;粘液性积液的SOM患者的内毒素检测阳性率和浓度 (分别为 68.1%和 387± 2 3.32EU/ml)高于浆液性积液的SOM患者 (分别为 2 1.1%和 37± 11.35EU/ml) ,P 值均 <0 .0 5。 88耳SOM经鼓膜穿刺治疗后 51耳复发 ,复发组的内毒素含量明显高于痊愈组 (P <0 .0 5) ,且第 2次复发的SOM患者的内毒素含量更高。结论 内毒素在SOM ,特别是在复发性SOM和儿童粘液型SOM病程中起重要作用。

Objective To study the relationship between endotoxin content and the recurrence of secretory otitis media (SOM). Methods The endotoxin content of 88 middle ear effusion from 66 patients with SOM was investigated with the Limulus assay technique at different stages. Results Both the positive rate and the concentration of endotoxin in SOM patients younger than 14 years, 77.2% and 402± 22.24 EU/ml, were higher than those in patients older than 15 years, 18.9% and 23± 5.98 EU/ml respectively; Both the positive rate and the concentration of endotoxin in SOM patients with mucoid middle ear effusion (MEE), 68.1% and 387± 23.32 EU/ml respectively, were also higher than those of SOM patients with serous MEE, 21.1% and 37± 11.35 EU/ml respectively (P< 0.05 in all. Fifty-one ears of 88 ears with SOM experienced recurrence after the treatment by myringopuncture. The endotoxin content in MEE from the recurrence group was significantly higher than that from the cured group (P< 0.05 ). Conclusion Endotoxin might play an important role in the pathological course of SOM, especially in the persistence or recurrence of SOM in children with mucoid MEE.