结核性中耳炎13例临床分析及T淋巴细胞斑点试验的辅助诊断意义  

Clinical features of 13 patients with tuberculous otitis media and the application of T-cell enzyme-linked immunospot assay in the assistant diagnosis

作　　者：王晋超[1] 陆金山[1] 吾买尔.牙生 顾兴智[1] 唐亮[1] 张劲[1] WANG Jin-ehao LU Jin-shan WUMAI＇ ER · Ya-sheng GU Xing- zhi TANG Liang ZHANG Jin.(Department of Otolaryngology, Xinjiang Uyghur Autonomous Region People＇ s Hospital, Urumqi 833000, Chin)

机构地区：[1]新疆维吾尔自治区人民医院耳鼻喉科,乌鲁木齐833000

出　　处：《中国眼耳鼻喉科杂志》2017年第4期275-278,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨结核性中耳炎的临床特点、手术疗效以及T淋巴细胞斑点试验(T-SPOT.TB)在结核性中耳炎患者中的临床应用价值。方法回顾分析2012~2015年我科收治的13例(15耳)结核性中耳炎的临床表现、影像学特征、治疗方法以及预后。每例患者进行外周血T-SPOT.TB检测,将T-SPOT.TB结果与最终诊断进行比较。结果 13例患者行T-SPOT.TB检查,结果为阳性。4例患者予以抗结核药物治疗,于3~4个月后渗出逐渐消失。另外9例(10耳)患者接受了手术治疗,术后予以抗结核药物治疗。术后1~3个月耳溢液逐渐消失,术腔上皮化良好,无肉芽组织形成。结论 T-SPOT.TB显示了较高的准确度,可用于结核性疾病的辅助诊断;手术结合抗结核药物治疗对结核性中耳炎有较高的治愈率。Objective To analyze the clinical features and the surgical outcomes of patients with tuberculous otitis media, and to observe the value of T-cell enzyme-linked immunospot assay （T-SPOT. TB ） in this disease. Methods From 2012 to 2015,13 cases of tuberculous otitis media （15 ears） were retrospectively investigated, including their clinical manifestations, radiological features, treatment and prognosis. T-SPOT. TB was carried out in every patient. Results By T-SPOT. TB, the positive rate in 13 patients was 100% （ 13/13 ） ,which was consistent with the pathology examination. Four patients were treated only with anti-tuberculosis chemotherapy and the otorrhea stopped after 3 to 4 months. Surgical treatment combined with anti-tuberculosis chemotherapy were given to 9 patients with ear discharge gradually disappearing, cavity well epithelized and without granulation tissue formation after 3 to 4 months. Conclusions T-SPOT. TB has certain application on value for detecting tuberculous otitis media for its higher accuracy. The patients who received surgery and anti-tuberculosis chemotherapy achieved more rapid healing of the ear.

关 键 词：结核性中耳炎 T淋巴细胞斑点试验 手术治疗 抗结核药物治疗 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]