分泌性中耳炎与胃食管反流病的关系研究

Relationgship between Secretory Otitis Media and Gastroesophageal Reflux Disease

目的：探讨分泌性中耳炎与胃食管反流病（ GERD）的关系。方法选取2012年7月-2013年11月青海大学附属医院耳鼻喉科依据全国最新的分泌性中耳炎诊断标准确诊的分泌性中耳炎患者45例，将内镜下发现反流性食管炎、Demeester积分≥14.72分者作为GERD组，余下患者作为非GERD组。采集患者鼓室积液检测胃蛋白酶水平。比较GERD组和非GERD组胃蛋白酶阳性率；将标准胃蛋白酶稀释为0.1～10.0μg/ml，读取样本在波长为450 nm处的吸光度值，绘制标准曲线计算样本胃蛋白酶水平。结果 GERD组患者33例和非GERD组12例。GERD组患者鼓室积液胃蛋白酶阳性率为39.4%（13/33），高于非GERD组患者鼓室积液胃蛋白酶阳性率8.3%（1/12），差异有统计学意义（χ^2＝8.01，P﹤0.05）。根据标准胃蛋白酶在波长为450 nm处绘制的标准曲线，测得GERD患者鼓室积液中胃蛋白酶水平为（0.66±0.46）μg/ml。结论反流的胃内容物可能进入中耳引发分泌性中耳炎，为临床进一步研究提供了参考依据。

Objective To investigate the relationship between secretory otitis media （SOM） and gastroesophageal reflux disease （GERD）. Methods From July 2012 to November 2013, 45 SOM patients in Department of ENT, Qinghai Uni- versity Medical CoUege were divided into groups GERD （ endoscope discovering GERD, DeMeester scores ≥ 14.72） , non - GERD. Tympanic fluidify was collected to determine the level of pepsase （PPS）. The positive rates of pepsin （PPS） were compared between 2 groups. The standard PPS was diluted to 0. 1 - 10.0 μg/ml, absorbance value of samples at 450 nm wave length was read, a standard curve drawn to calculate the level of PPS of samples. Results 33 cases in GERD group and non - GERD group of 12 cases. The positive rate of PPS was 39.4% （ 13/33 ） in group GERD, higher than in group non - GERD [ 8.3% （1/12） 3, the difference was significant （ χ^2 = 8. 01, P 〈 0. 05）. By the standard curve of PPS drawn at 450 nm wave length, the level of PPS was （0. 66 ± 0. 46） μg/ml. Conclusion Reflux of gastric contents may enter the nasopharynx and middle ear to initiate SOM, which provides references for further clinical research.