儿童分泌性中耳炎中耳腔胃蛋白酶和胃蛋白酶原的表达及临床意义  

The expression and clinical significance of pepsin and pepsinogen in patients with otitis media with effusion

作　　者：罗花南[1] 高滢[1] 马思敬 杨启梅[2] 邵娜[1] 张阿玲[1] 许珉[1] 

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科病院,西安710004 [2]陕西省人民医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第14期1252-1255,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：西安交通大学第二附属医院青年基金资助项目[No:YJ(QN)201124]

摘　　要：目的:分析胃蛋白酶、胃蛋白酶原在儿童分泌性中耳炎(OME)中的作用及意义。方法:将2012-05-2012-12期间需行鼓膜穿刺(置管术)的38例(48耳)OME患儿作为实验组,同期不伴有中耳炎、需行人工耳蜗植入的10例(10耳)患儿作为对照组。收集2组患儿中耳灌洗液和血浆样本,运用酶联免疫方法检测样本的胃蛋白酶、胃蛋白酶原Ⅰ浓度。结果:实验组中耳灌洗液中胃蛋白酶和胃蛋白酶原的浓度分别为(48.80±415.99)、(676.32±336.71)ng/ml,显著高于对照组[(8.20±4.59)、(77.27±50.33)ng/ml],2组差异有统计学意义(均P<0.01)。实验组中耳灌洗液胃蛋白酶原Ⅰ浓度高于血浆浓度,差异有统计学意义(P<0.01)。OME患儿干耳组其中耳灌洗液胃蛋白酶浓度显著低于浆液组、黏液组(P<0.01),而浆液组和黏液组间胃蛋白酶浓度差异无统计学意义(P>0.05)。干耳组、浆液组、黏液组中耳灌洗液胃蛋白酶原Ⅰ浓度差异无统计学意义(P>0.05)。结论:OME患儿中耳腔的胃蛋白酶、胃蛋白酶原可能来源于咽喉反流,咽喉反流与儿童OME的发病有关。Objective：To analyze the role and significance of pepsin and pepsinogen in the pathogenesis of OME in children.Method：Pediatric patients with otitis media aged 2-8years who enrolled in our department of the hospital from May of 2012 to December of 2012 were set as experimental group（38cases,48ears）,which should be underwent tympanic membrane puncture/tube insertion.Meanwhile,pediatric patients waiting for cochlear implant without otitis media（10ears）,were set as control group.Middle ear lavage fluid and plasma samples from the two groups were collected and detected using enzyme-linked immune method for pepsin and pepsinogen.Result：The concentrations of pepsin and pepsinogen in the middle ear lavage fluid of OME group[（48.8±415.99）ng/ml and 676.32±336.71）ng/ml]were significantly higher than those in the control group[（8.20±4.59）ng/ml and（77.27±50.33）ng/ml]（P〈0.01）.Meanwhile,the concentration of pepsinogen in the middle ear lavage of OME patients was significantly higher than that of plasma（P〈0.01）.The concentration of pepsin in the middle ear lavage fluid from the dry ear subgroup was lower than those in the serum ear and mucous ear subgroups（P〈0.01）,but there was no significant difference about concentrations of pepsinogen among the dry ear,serum ear and mucous ear subgroups（P〈0.05）.Conclusion：Pepsin and pepsinogen in the middle ear cavity of OME patients maybe originated from laryngopharyngeal reflux（LPR）,indicating that LPR is associated with the pathogenesis of OME in children.

关 键 词：分泌性中耳炎 咽喉反流 胃蛋白酶 胃蛋白酶原 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]