儿童分泌性中耳炎中耳积液中鼻病毒检测意义及相关因素分析

Significance of detection of rhinovirus in middle ear effusions of children with secretory otitis media and analysis of correlated factors

目的探讨分泌性中耳炎患儿中耳积液鼻病毒检测的临床意义及中耳积液鼻病毒感染的相关危险因素。方法选取2019年2—8月在河北省儿童医院住院手术的111例分泌性中耳炎患儿,入院后采集病史完善检查,术前抽取静脉血行血清过敏原筛查,术中留取中耳积液标本行鼻病毒PCR检测。根据鼻病毒PCR检测结果分为鼻病毒阳性组和鼻病毒阴性组,比较2组患儿性别、年龄、病情分期、出生时孕周、喂养方式及慢性鼻窦炎、腺样体肥大、扁桃体肥大发生情况和过敏原筛查结果。结果鼻病毒阳性组24例,鼻病毒阴性组87例,鼻病毒阳性组患儿年龄中位数显著低于鼻病毒阴性组(P<0.05),学龄前患儿占比、急性-亚急性期患儿占比显著高于鼻病毒阴性组(P均<0.05),2组患儿性别、出生时孕周、喂养方式及慢性鼻窦炎、腺样体肥大、扁桃体肥大发生率和过敏原阳性率、过敏原阳性项数之间比较差异均无统计学意义(P均>0.05)。结论儿童分泌性中耳炎的发生可能与鼻病毒引发的上呼吸道感染有关,中耳积液鼻病毒感染常发生于小年龄患儿及分泌性中耳炎早期阶段,与过敏原刺激及过敏易感体质无关,预防上呼吸道感染将有利于疾病恢复。

Objective It is to investigate the clinical significance of rhinovirus detection in middle ear effusions of children with secretory otitis media and the risk factors of middle ear effusion rhinovirus infection.Methods One hundred and eleven children with secretory otitis media who were treated with operation in Children's Hospital of Hebei Province from February to August in 2019 were selected,their medical history was invested and examination was completed after admission.Before the operation,venous blood was collected for serum allergen screening,and the middle ear effusion samples were collected during the operation for rhinovirus PCR detection.According to the results of rhinovirus PCR,the patients were divided into rhinovirus positive group and rhinovirus negative group,to compare the gender,age,disease stage,gestational age at birth,feeding method,occurrence of chronic sinusitis,adenoid hypertrophy,tonsil hypertrophy,and allergen screening results of the children were compared between the two groups.Results There were 24 cases in rhinovirus positive group and 87 cases in rhinovirus negative group.The median age of the rhinovirus positive group was significantly lower than that of the rhinovirus negative group(P<0.05),while the proportion of pre-school children and the children at acute-subacute phase were significantly higher than those of the rhinovirus negative group.There was no significant differences in gender,gestational age at birth,feeding method,occurrence of chronic sinusitis,adenoid hypertrophy,tonsil hypertrophy,positive rate of allergen and the positive number of allergen between the two groups(P>0.05).Conclusion Occurrence of secretory otitis media in children may be related to upper respiratory tract infection caused by rhinovirus,middle ear effusion rhinovirus infection usually occurs in young children and early stages of otitis media with effusion,it has no correlation with allergen stimulation and allergic constitution,and prevention of upper respiratory tract infection will contribute to the recovery of this disease.