儿童反复发作型中耳炎与腺样体肥大的相关性研究  

The correlation sstudies between recurrent otitis media and adenoid hypertrophy in children

作　　者：刘卫卫[1] 张淑君[2] 张宇丽[2] 岳卓立[2] 尹桂茹[2] 

机构地区：[1]沧州市中心医院耳鼻咽喉科,河北沧州061000 [2]承德医学院附属医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第13期722-725,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2011河北省科技厅指令性课题(No:JB0011276103D-82)

摘　　要：目的:探讨腺样体免疫状况与分泌性中耳炎(SOM)的相关性。方法:采用免疫组织化学SP法检测30例反复发作SOM、17例非反复发作SOM及20例单纯腺样体肥大(无中耳炎病史)患儿腺样体组织中PCNA、BCL-2,CD4+、CD8+的表达及CD4+/CD8+的值。结果:反复发作SOM组PCNA、BCL-2、CD4+、CD8+表达阳性细胞数及CD4+/CD8+分别为30.85±1.73、21.27±1.25、41.90±9.07、20.45±7.08、2.10±0.17,显著高于非反复发作组(25.50±1.66、14.23±1.06、17.40±6.85、13.02±5.88、1.33±0.11,均P<0.01)及单纯腺样体肥大组(25.25±1.75、14.05±1.02、16.30±8.21、11.15±5.71、0.39±0.15,均P<0.01);后2组间各指标比较均差异无统计学意义(均P>0.05)。性别及腺样体大小3组间差异无统计学意义(P>0.05)。单纯腺样体肥大组中>6～10岁、>10～14岁与3～6岁PCNA比较差异有统计学意义(P<0.05)。结论:反复发作的SOM患儿腺样体中T淋巴细胞亚群活性增高,处于增殖期细胞增多,致使腺样体增生肥大,同时局部免疫增强,加重了SOM。年龄及性别与SOM的发生无关,但低龄是腺样体肥大的影响因素。反复发作的SOM患儿伴腺样体肥大时,应尽早行腺样体切除术。Objective：To investigate the relationship between the immune status of adenoids and secretory oti tis media（SOM）. Method：The adenoids tissue samples of 30 cases of recurrent secretory otids media（ SOM）, 17 ca- ses of non recurrent secretory odds media and 20 cases of the adenoids hypertrophy without SOM were studied by immunohistochemical method. Result：The expression of PCNA,BCL-2,CD4＋ ,CD8＋ cells and CD4＋ /CD8＋ in re current SOM tissue were .30.85±1.73,21.27±1.25,41.90±9.07：20.45±7.08 and 2. 10±0. 17, respectively, which was remarkably higher than those of non recurrent SOM,（25. ,50±1. 66,14. 23 ±1. 06,17. 40 ± 6. 85, 13.02±5.88,1.33 ±0.11,respectively） and those of simple adenoid hypertrophy（25.25±1. 75,14.05±1.02, 16. 30±8.21,]1.15±5.71 and 1.39±0.15,respecticvely）（P〈0.01） ; the difference of the expression of PCNA, BCL-2,CD44 ,CD8＋ and CD4＋/CD8＋ between the latter two groups was not significant. Differences of the gender or the size were not significant（P〈0.05）. In group of simple adnoid hypertrophy, PCNA in lhe subgroup of the age 3 to 6 was significantly higher than those in the other groups（P〈0.05）. Conclusion：In adenoid tissues of re current SOM patients, the activities of T lymphocyte subsets cells in hypertrophic status increase, the adenoids enlarge and local immunity enhances. The age and gender have nothing to do with the SOM, but low age is one of the influencing factors of adenoid hypertrophy. Therefore ,adenoidectomy for recurrent SOM patients with adenoid hypertrophy should be carried out as early as possible.

关 键 词：儿童 分泌性中耳炎 腺样体 PCNA BCL-2 CD4+ CD8+ 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]