渗出性中耳炎患者血清和渗出液中免疫球蛋白浓度与微生物学的关系

Immunoglobulin concentrations in serum and exudate of patients with exudative otitis media in relation to microbiology

目的探讨渗出性中耳炎患者血清和渗出液中免疫球蛋白浓度与微生物学的关系。方法选取本院就诊的118例渗出性中耳炎患者作为研究对象,记为渗出性中耳炎组,选取同时期在本院体检者50例作为对照组。检测血清及耳积液中免疫球蛋白水平。根据渗出性中耳炎患者病原菌培养结果分为病原菌阳性组49例及病原菌阴性组69例,检测病原菌与血清及渗出液免疫球蛋白的关系。结果与对照组相对比,渗出性中耳炎组血清IgA、IgG、IgM水平均显著升高(P<0.05);渗出性中耳炎组渗出液免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平较血清IgA、IgG、IgM水平均显著升高(P<0.05)。118例渗出性中耳炎患者共检测出病原菌109株,其中,流感嗜血杆菌(33株)占比最高,占30.28%,其次为金黄色葡萄球菌(30株),占27.52%,肺炎链球菌(22株)占20.18%。118例渗出性中耳炎患者病原菌阳性49例,占41.53%。与病原菌阴性组对比,病原菌阳性组患者血清IgA、IgG、IgM水平均显著升高(P<0.05)。与病原菌阴性组对比,病原菌阳性组患者渗出液IgA、IgG、IgM水平较高,但差异无统计学意义(P>0.05)。结论渗出性中耳炎患者血清免疫球蛋白浓度可能受渗出液中微生物存在的影响,而渗出液中免疫球蛋白浓度可能不受渗出液中微生物存在的影响。

Objective To explore the relationship between immunoglobulin concentration in serum and exudate of patients with exudative otitis media and microbiology.Methods 118 patients with exudative otitis media who visited our hospital were selected as the study subjects,designated as the exudative otitis media group,and 50 patients who underwent physical examinations at the same time in our hospital were selected as the control group.Detect immunoglobulin levels in serum and ear fluid.According to the pathogen culture results of patients with exudative otitis media,they were divided into a pathogen positive group of 49 cases and a pathogen negative group of 69 cases.The relationship between pathogens and serum and exudate immunoglobulins was detected.Results Compared with the control group,the serum levels of IgA,IgG,and IgM in the exudative otitis media group were significantly increased(P<0.05);The levels of immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)in the exudate of the otitis media group were significantly higher than those in the serum(P<0.05).A total of 109 strains of pathogenic bacteria were detected in 118 patients with exudative otitis media.Among them,the highest proportion was Haemophilus influenzae(33 strains),accounting for 30.28%,followed by Staphylococcus aureus(30 strains),accounting for 27.52%,and Streptococcus pneumoniae(22 strains),accounting for 20.18%.Among 118 patients with exudative otitis media,49 were positive for pathogens,accounting for 41.53%.Compared with the pathogen negative group,the serum levels of IgA,IgG,and IgM in the pathogen positive group were significantly increased(P<0.05).Compared with the pathogen negative group,the pathogen positive group had higher levels of IgA,IgG,and IgM in the exudate,but the difference was not statistically significant(P>0.05).Conclusion The serum immunoglobulin concentration in patients with exudative otitis media may be influenced by the presence of microorganisms in the exudate,while the immunoglobulin concentration in the exudate may not be affected by the presence of microorganisms in the exudate.