糖皮质激素治疗成人亚急性分泌性中耳炎的疗效分析及对患者血浆TNF-α、IL-10作用的研究  

Effect of glucocorticoid on subacute otitis media with effusion and its affection on TNF-α、IL-10 in blood plasma in adults

作　　者：李智 李阳[2] 王宇娟[2] 贾艳萍[2] 许珉[1] 

机构地区：[1]西安交大医学院第二附属医院,710068 [2]陕西省人民医院耳鼻咽喉科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2013年第6期406-409,412,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨糖皮质激素治疗成人亚急性性分泌性中耳炎的疗效以及在转归中的可能作用机制。方法回顾性分析经鼓膜穿刺治疗的成人亚急性OME患者60例,比较激素治疗组,即糖皮质激素治疗+术后口服糖皮质激素组(实验组)与仅鼓室内非激素药物治疗(对照组)的治疗效果;使用ELISA法检测和比较2组患者中耳积液与外周血浆的表达水平的变化,手术前后外周血浆中TNF-α、IL-10表达水平的变化。结果激素治疗组的治疗有效率显著高于非激素治疗组(P<0.05),复发率明显低于非激素治疗组(P<0.05);TNF-α、IL-10在中耳积液中的含量显著高于外周血浆中含量(P<0.05),激素组患者术后3天、10天血清中的TNF-α较对照组明显下降(P<0.05);而IL-10含量术后3天较非激素组显著升高(P<0.05),而术后10天显著下降(P<0.05)。结论糖皮质激素是治疗成人亚急性分泌性中耳炎的有效手段,可能通过提高血浆中的IL-10来抑制TNF-α的释放来达到抑制炎症的作用。Objective To investigate curative effect and mechanism of glucocorticoid on adult subacute otitis media with effusion （OME）. Method To analyze 60 patients of subacute OME after auripuncture treatment. The experimental group was treated by glucocorticoid and glucocorticoid peroral administration after operation. The control group was treated by non-hormone drug through tympanic cavity only. We detected and compared the middle ear effusion and expression diversity of peripheral blood plasma in the two groups, and compared TNF-ct. IL-10 content in peripheral blood plasma pre and post surgery. Result Therapy effective power in the hormone therapy group was higher notably than that in non-hormone therapy group （P〈0.05）. The recurrence rate in the hormone therapy group was lower than that in non-hormone therapy group （P〈0.05）. TNF-α and IL-10 content in the middle ear effusion was higher than those in the peripheral blood plasma （P〈0.05）. TNF-a of blood serum in the hormone therapy group on 3 days and 10-days after surgery decreased obviously than that in the non-hormone therapy group. IL-10 content the in hormone therapy group on 3 days after surgery advanced significantly than that in the non-hormone therapy group （P〈0.05）, but decreased on 10 days after surgery （P〈0.05）. Conclusion Glucocorticoid was effective for treating subacute otitis media with effusion in the adults. Glucocorticoid could elevate IL-10 in blood plasma and inhibit TNF-α releasing to control inflammation.

关 键 词：分泌性中耳炎 鼓室积水 细胞因子 TNF-A IL-10 

分 类 号：R764[医药卫生—耳鼻咽喉科]