中耳细菌感染对内耳及机体免疫功能长期影响的实验观察  

An observation on long term influence of middle ear bacterial infection on inner ear function and systemic immune reaction

作　　者：邹静[1] 毕爱芳[1] 杨伟炎[2] 周永清[1] 丁卫东[3] 郝晓东[3] 

机构地区：[1]石家庄白求恩国际和平医院耳鼻咽喉科全军耳鼻咽喉疾病中心,050082 [2]解放军总医院耳鼻咽喉科解放军耳鼻咽喉科研究所 [3]石家庄白求恩国际和平医院,050082

出　　处：《中华耳鼻咽喉科杂志》2000年第3期196-199,I013,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　探讨中耳细菌感染后内耳热休克反应是否会长期存在 ,及其对内耳功能的潜在影响。方法　 6 0只BALB/c鼠随机分为肺炎克雷白杆菌、金黄色葡萄球菌 (简称金葡菌 )、绿脓杆菌、大肠杆菌、变形杆菌和生理盐水对照 6个组 ,每组 10只。中耳注射致病菌 135d后测试畸变产物耳声发射并取材进行光镜与电镜观察 ,检测内耳热休克蛋白 (heatshockprotein ,HSP) 70相关表位分子的表达 ,行单个核细胞核因子κBp6 5和抗肺炎克雷白杆菌抗体、抗膜迷路蛋白抗体的测试。结果　所有标本核因子κBp6 5未发生明显核内转移。金葡菌感染组 3只、肺炎克雷白杆菌组和变形杆菌组 2只、绿脓杆菌组 3只以及对照组 1只动物的抗肺炎克雷白杆菌抗体阳性。经外加电场固定液相分子快速斑点免疫分析筛选 ,金葡菌感染组 2只、肺炎克雷白杆菌组 2只、绿脓杆菌组和生理盐水对照组各 1只抗膜迷路蛋白抗体阳性 ,其中金葡菌组和肺炎克雷白杆菌组抗膜迷路蛋白和抗肺炎克雷白杆菌双阳性。经免疫转印分析 ,其阳性条带除 1例相对分子质量为 6 80 0 0以外 ,其余均为小分子 ,以 2 6 0 0 0～ 30 0 0 0为主 ,380 0 0～ 410 0 0次之 ,46 0 0 0～ 5 0 0 0 0有微弱反应。除变形杆菌组右耳和绿脓杆菌组左耳 16 2 5Hz畸变产物耳声发射检测显著异常外 。Objective To understand whether long term inner ear heat shock response related to heat shock protein(HSP70) caused by middle ear bacterial infection and the potential influence on inner ear function Methods Sixty BALB/c mice were randomly classified into 6 groups including Klebsiella pneumoniae(KP), Staphylococcus aureus, Bacillus pyocyaneus, Bacillus coli, Bacillus proteus and physiological saline control groups On 135 days after injection, distortion product otoacoustic emissions(DPOAE) was tested and all the samples were collected, which were examined with light and electronic microscopes HSP70 related molecule expression in inner ear, nuclear factor (NF)κ Bp65 characterization in mononuclear cell, anti KP antibody and anti membranous labyrinth proteins (MLP) were examined. Results No nuclear transfer of NF κ Bp65 was observed in any animal Anti KP antibody was detected in 30% (3/10) of Staphylococcus aureus group, 29% (2/7) of KP group, 33% (3/9) of Bacillus pyocyaneus group and 10% (1/10) of control group Anti MLP antibody was created in 20% (2/10) of Staphylococcus aureus group, 20% (2/10) of KP group, one each in Bacillus pyocyaneus group and control group respectively Double positive antibody against KP and MLP were found in Staphylococcus aureus group and KP group When analyzed with Western blot, all the positive bands were small molecules including strongest 26 000～30 000,medium degree 38 000～41 000 and weak 46 000～50 000 except for 68 000 in one case There was only one significant DPOAE amplification decrease at 1 625 Hz (2f 1 f 2) in left ear of Bacillus pyocyaneus group and right ear of Bacillus proteus group No abnormal phenomenon was found in inner ear both under light microscope and electronic microscope No significant expression of HSP70 was observed in inner ears Conclusion No long term heat shock response related to HSP70 existed in the inner ear and the immune inner ear damage may be caused by multiplefactors

关 键 词：中耳炎 细菌感染 迷路 热休克蛋白质类 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]