腺样体肥大患儿鼻咽部分泌物中胃蛋白酶的检测  

Detection of pepsin in nasopharyngeal secretions in children with adenoid hypertrophy

作　　者：张春林[1] 李柳金 李春雷[1] 林季珍[1] 邓泽义[2] 王科[1] 刘兆辉[1] 

机构地区：[1]遵义医学院附属医院耳鼻咽喉头颈外科,贵州遵义563003 [2]南方医科大学珠江医院耳鼻咽喉头颈外科,广东广州510282

出　　处：《中国现代医学杂志》2016年第23期68-71,共4页China Journal of Modern Medicine

基　　金：贵州省科技厅联合基金(No:黔科合J字LKZ[2012]06号)

摘　　要：目的检测腺样体肥大（AH）患儿鼻咽部分泌物中胃蛋白酶的表达,并探讨其与AH的关系。方法选取AH患儿作为实验组,收集无腺样体和扁桃体肥大的患儿作为对照组,采用酶联免疫吸附试验检测鼻咽部分泌物和腺样体组织中胃蛋白酶的表达,并进行比较。分别根据AH合并或不合并扁桃体肥大和腺样体的肥大程度对实验组进行分组,比较亚组间胃蛋白酶的表达。结果实验组和对照组中胃蛋白酶浓度和阳性率分别为（2.801±1.544）和（1.074±0.387）ng/ml,55.8%（24/43）和0.0%（0/22）,差异有统计学意义（P=0.000）。实验组亚组分析,AH不伴扁桃体肥大（A组）和AH伴有扁桃体肥大（B组）的胃蛋白酶浓度和胃蛋白酶阳性率分别为（2.907±1.694）和（2.699±1.420）ng/ml,57.1%（12/21）和54.5%（12/22）,差异无统计学意义（P=0.568和0.864）;腺样体Ⅱ度大亚组（堵塞后鼻孔〉75%）中胃蛋白酶浓度和阳性率均高于腺样体Ⅰ度大亚组（堵塞后鼻孔50%-75%）,差异有统计学意义（P=0.000和0.046）。结论部分AH患儿的鼻咽部分泌物中检测到胃蛋白酶,胃内容物的鼻咽部反流可能与AH有一定的关系。Objective To detect pepsin in the nasopharyngeal secretions in children with adenoid hypertrophy（AH）, and then to explore its association with AH. Methods The pediatric AH patients and the pediatric patients without AH or tonsil hypertrophy（TH） were collected as experiment group and control group, respectively. The pepsin level in the nasopharyngeal secretions and adenoid tissues was detected using an enzyme linked immunosorbent assay kit, and then compared between the experiment group and the control group.Moreover, the experimental group was divided into subgroups according to the combination with TH（subgroup B） or not（subgroup A） and the degree of adenoid hypertrophy, respectively. The pepsin level was compared between the subgroups. Results The expression level and the positive rate of pepsin in the nasopharyngeal secretions in the experiment group and the control group were（2.801 ± 1.544） and（1.074 ± 0.387） ng/ml, and55.8%（24/43） and 0.0%（0/22）, respectively, the differences were statistically significant（P = 0.000）. In the experiment group, the pepsin level and positive rate in the subgroup A and the subgroup B were（2.907 ±1.694） and（2.699 ± 1.420） ng/ml, and 57.1%（12/21） and 54.6%（12/22） respectively, there were no significant differences（P = 0.568 and 0.864）. Compared with the subgroup of degree I adenoid hypertrophy（50%-75%posterior nose blockage）, significantly higher concentration and positive rate of pepsin were found in the subgroup of degree Ⅱ adenoid hypertrophy（ 〉75% posterior nose blockage, P = 0.1913 and 0.3211）.Conclusions Pepsin in the nasopharyngeal secretions is found in a relatively high proportion of AH patients,and there is most likely an association between the nasopharyngeal reflux of gastric contents and AH.

关 键 词：腺样体肥大 胃内容物反流 鼻咽反流 胃蛋白酶 

分 类 号：R765[医药卫生—耳鼻咽喉科]