小儿分泌性中耳炎耳积液中CD44和TLR4表达与腺样体肥大的相关性

The correlation between the expression of CD44 and TLR4 in the ear effusion of children with secretory otitis media and adenoid hypertrophy

目的检测小儿分泌性中耳炎患儿耳积液中分化簇44(CD44)和Toll样受体4(TLR4)表达水平,并分析二者与腺样体肥大的相关性。方法选取纳入80例小儿分泌性中耳炎患儿为观察组,选取同期接受健康体检的100例健康儿童为对照组。检测观察组患儿及对照组儿童耳积液中CD44和TLR4表达水平,并分析二者与腺样体肥大的相关性。采用Pearson法分析耳积液中CD44与TLR4表达水平的相关性。采用受试者工作特征(ROC)曲线分析CD44、TLR4对腺样体肥大的诊断价值。结果CD44、TLR4在观察组患儿外周血、耳积液中的表达水平相较于对照组儿童外周血中的表达水平显著升高(P<0.05);CD44、TLR4在观察组患儿耳积液中的表达水平相较于观察组患儿外周血中的表达水平显著升高(P<0.05);CD44、TLR4在观察组浆液性耳积液中的表达水平相较于黏液性耳积液中的表达水平显著降低(P<0.05);CD44、TLR4在观察组慢性中耳炎患儿耳积液中的表达水平相较于急性中耳炎耳积液中的表达水平显著降低(P<0.05);CD44、TLR4在腺样体肥大中耳炎患儿耳积液中的表达水平相较于腺样体正常中耳炎耳积液中的表达水平显著升高(P<0.05);小儿分泌性中耳炎耳积液中CD44和TLR4表达呈正相关(r=0.516,P=0.000)。CD44、TLR4二者联合诊断腺样体肥大的诊断价值显著高于二者单独诊断。结论CD44、TLR4均在小儿分泌性中耳炎耳积液中的表达水平上调,且相较于腺样体正常的患儿,腺样体肥大的患儿耳积液中CD44、TLR4表达水平显著升高,与腺样体肥大密切相关。

Objective To detect the expression levels of CD44 and TLR4 in the ear effusion of children with se-cretory otitis media(SOM)and analyze their correlation with adenoid hypertrophy.Methods Eighty children diagnosed with secretory otitis media were selected as the observation group,and 100 healthy children undergoing routine health ex-aminations during the same period were chosen as the control group.The expression levels of CD44 and TLR4 in the ear effusion of the observation group and peripheral blood of both groups were measured.The correlation between CD44 and TLR4 expression levels and adenoid hypertrophy was analyzed using Pearson's method.The diagnostic value of CD44 and TLR4 for adenoid hypertrophy was assessed using receiver operating characteristic(ROC)curve analysis.Results The expression levels of CD44 and TLR4 in the peripheral blood and ear effusion of children in the observation group were sig-nificantly higher than those in the peripheral blood of the control group(P<0.05).The expression levels of CD44 and TLR4 in the ear effusion of the observation group were significantly higher than those in the peripheral blood of the same group(P<0.05).In the observation group,the expression levels of CD44 and TLR4 in serous ear effusion were signifi-cantly lower than those in mucous ear effusion(P<0.05).Additionally,the expression levels of CD44 and TLR4 in the ear effusion of children with chronic otitis media were significantly lower than those in children with acute otitis media(P<0.05).Furthermore,the expression levels of CD44 and TLR4 in the ear effusion of children with adenoid hypertrophy and otitis media were significantly higher than those in children with normal adenoids and otitis media(P<0.05).There was a positive correlation between CD44 and TLR4 expression in the ear effusion of children with secretory otitis media(r=0.516,P=0.000).The diagnostic value of CD44 and TLR4 combined in diagnosing adenoid hypertrophy was significantly higher than that of either alone.Conclusion CD44 and TLR4 are upregulated in the ear effusion of children with secretory otitis media,and their expression levels are significantly increased in children with adenoid hypertrophy compared to those with normal adenoids,indicating a close association with adenoid hypertrophy.