腺样体切除术对儿童分泌性中耳炎TNF-α、IL-6和IL-8表达的影响

The effect of adenoidectomy on the expression of IL-8,IL-6 and TNF-α in the children with secretory otitis media

目的探讨腺样体切除术对儿童分泌性中耳炎肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)和IL-8表达的影响。方法将湖北省荆州市中心医院收治的126例患有分泌性中耳炎的儿童作为研究对象,按入院先后分为观察组(65例)、对照组(61例)。对照组患儿采用鼓膜置管术进行治疗,观察组则在进行鼓膜置管术的同时进行腺样体切除术。对两组患儿中耳积液时间、术后中耳积液复发率、感染率进行比较,同时比较治疗前后两组患儿的TNF-α、IL-6和IL-8以及听力阈值。结果观察组患儿的中耳积液时间以及中耳积液复发率、感染率均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿的血清TNF-α、IL-6和IL-8水平差异无统计学意义(P>0.05),治疗3个月后,观察组的各项血清炎性因子水平均明显低于对照组(P<0.05)。观察组患儿在各频率上的纯音听阈水平均明显高于对照组,差异有统计学意义(P<0.05)。结论腺样体切除术能够明显降低分泌性中耳炎患儿的TNF-α、IL-6和IL-8的水平,患儿的听力水平得到显著改善,值得在临床上推广。

Objective To explore the effect of adenoidectomy on the expression of interleukin-8（IL-8）,IL-6 and tumor necrosis factor-α（TNF-α）in children with secretory otitis media.Methods A total of 126 children with secretory otitis media were selected in our hospital as the research subjects.According to hospital admission,they were divided into the observation group（65 cases）and the control group（61 cases）.The patients in the control group treated with grommet insertion.At the same time,the patients in the observation group performed with the adenoidectomy.The middle ear effusion time,postoperative middle ear effusion recurrence rate,infection rate in two groups were compared.And before and after treatment,TNF-αand IL-6 and IL-8 and hearing threshold were compared in two groups.Results In the observation group,the middle ear effusion time,the rate of recurrence rate and infection rate of middle ear effusion were significantly lower than those of the control group（P〈0.05）.Before treatment,the serum levels of TNF-α,IL-6 and IL-8 had no significant differences between the two groups（P〈0.05）.After three months of treatment,the serum levels of inflammatory factors in the observation group were significantly higher than those in the control group（P〈0.05）.At the same time,the patients in the observation group in each frequency pure tone hearing threshold levels were significantly higher than those of the control group（P〈0.05）.Conclusion Adenoidectomy could the decrease level of TNF-α,IL-6 and IL-8 in children with secretory otitis media,and the hearing level of children with secretory otitis media is significantly improved,which is worth to be popularized in clinic.