鼓室内注射曲安奈德对分泌性中耳炎患者血清白细胞介素-4和干扰素-γ的影响

Effect of intratympanic injection of triamcinolone acetonid on IL - 4 and IFN - γ in patients with secretory otitis media

目的观察鼓室内注射曲安奈德对分泌性中耳炎患者血清白细胞介素-4（IL-4）和干扰素-γ（IFN-γ）的影响。方法选取分泌性中耳炎患者110例为研究对象，采用随机数字表法分为两组，观察组55例，对照组55例。患者均首先进行鼓室内穿刺抽液，对照组鼓室内注射地塞米松，观察组鼓室内注射曲安奈德，两组治疗2次／周，连续治疗1个月。治疗前后空腹抽血测定血清IL-4和IFN-γ。结果对照组总有效率为58．2％，观察组总有效率为70．9％，观察组总有效率明显高于对照组（Х^2=4．68，P〈0．05）。两组治疗后血清1L-4、IL-4／IFN-γ均有明显降低（t=4．698、10．262、3．924、4．264，均P〈0．01）；两组治疗后血清IFN-γ均有明显升高（t=3．016、5．116，均P〈0．05）。与对照组治疗后比较，观察组治疗后血清IL-4、IL-4／IFN-γ降低更明显（t=3．082、2．971，均P〈0．01）；血清IFN-1升高更明显（t=2．142，P〈0．05）。结论鼓室内注射曲安奈德可以明显提高分泌性中耳炎患者疗效，改善Th1／Th2平衡。

Objective To study the effect of intratympanic injection of triamcinolone acetonid on interleukin- 4（IL- 4） and interferon-gamma （IFN -γ） in patients with secretory otitis media. Methods 110 patients with secretory otitis media were selected, and they were randomly divided into the observation group and control group according to digital table,55 cases in each group. All patients were treated with puncture in the tympanic cavity. The control group was injected with dexamethasone, while the observation group was injected with triamcinolone acetonid. Two groups were treated for 2 times/week, continuous treatment for 1 month. Fasting blood samples were collected before and after treatment to determine serum IL - 4 and IFN -γ levels. Results The total effective rate of the control group was 58.2%, which was significantly lower than 70.9% of the observation group （ Х^2 = 4.68, P 〈 0. 05 ）. After treatment, the serum levels of IL - 4 and IL - 4/IFN - γ in the two groups were significantly decreased （t = 4. 698,10. 262,3. 924,4. 264, all P 〈 0.01 ）. After treatment, the serum IFN - γ levels were significantly higher in the two groups （ t = 3.016,5.116, all P 〈 0.05 ）. Compared with the control group after treatment, the serum IL - 4, IL - 4/IFN - γ in the observation group decreased more significantly （ t = 3. 082,2. 971, all P 〈 0.01 ）. The serum IFN - γ level increased significantly （ t = 2. 142, P 〈 0. 05 ）. Conclusion Triamcinolone acetonid intratympanic injection can significantly improve the efficacy in patients with secretory otitis media, and improve the balance of Th1/Th2.