肺表面活性物质滴鼻治疗分泌性中耳炎的形态学观察  

A Morphological study of Eustachian Tube in Otitis Media with Effusion after Treatment with Intranasal Pulmonary Surfactant

作　　者：朱正华[1] 单颖军[1] 韩扬[2] 朱黎伟[1] 马兆鑫[1] 

机构地区：[1]同济大学附属东方医院耳鼻喉科,上海200120 [2]同济大学附属东方医院病理科,上海200120

出　　处：《中华耳科学杂志》2012年第4期510-513,共4页Chinese Journal of Otology

基　　金：上海市浦东新区卫生局科技基金面上项目(PW2009A-2)

摘　　要：目的肺表面活性物质滴鼻治疗分泌性中耳炎,观察咽鼓管的组织病理变化。方法鼓室内注射灭活的流感嗜血杆菌,建立豚鼠分泌性中耳炎的动物模型。50只豚鼠随机取10只作为正常组;40只造模,31只造模成功(听力下降,双侧中耳积液),再随机分为3组。造模组10只;生理盐水组10只;肺表面活性物质治疗组(D)11只。观察各组咽鼓管粘膜的组织病理学变化。结果比较各组咽鼓管光镜下的组织病理学变化,发现造模组和生理盐水组咽鼓管粘膜肿胀,杯状细胞增生,纤毛倒伏、排列紊乱、部分脱落;PS治疗组咽鼓管粘膜稍肿胀,纤毛排列整齐、无倒伏,与正常组相似。结论肺表面活性物质滴鼻对分泌性中耳炎咽鼓管粘膜纤毛系统具有抗炎、保护纤毛结构的作用。Objective To evaluate the effect of pulmonary surfaetant （PS） on histopathology of Eustachian tube （ET） in guinea pigs with otitis media with effusion （OME）. Methods Intratympanic injection of inactivated Haemophilus influenza was used to establish a guinea pig animal model of OME. From 50 guinea pigs, 10 were randomly selected as the normal control. OME modeling was attempted in the rest 40 animals and successful in 31 who subsequently demonstrated hearing loss and bilateral middle ear effusion. The 31 animals were then randomly divided into three groups to receive no treatment （n=10）, treatment with saline （n=10） or treatment with pulmonary suffactant （PS, n=11）. The histopathologic changes in these guinea pigs were examined and compared by light microscopy . Results In the untreated and saline-treated groups, mucosa showed swelling,with irregularly arranged, lodged and sometimes lost cilia and hyperplasia of the goblet cells. In the PS-treated group, there was slight mucosa swelling, with regularly arranged cilia in concord showing no falling, similar with the normal control group. Conclusion Pulmonary surfactant plays an important role in anti-inflammation and protection of eillia of the ET mueociliary system in OME.

关 键 词：分泌性中耳炎 肺表面活性物质 咽鼓管 滴鼻 病理 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]