分泌性中耳炎患者手术前后血清和中耳积液中β2-M、S-IgA及炎性因子水平变化  

Changes of β2-M,S-IgA and Inflammatory Factors in Serum and Middle Ear Effusion of Patients with Secretory Otitis Media Before and After Surgery

作　　者：王玲[1] 罗伟[1] 文科[1] 黄朝平[1] WANG Ling;LUO Wei;WEN Ke;HUANG Chao-ping(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院耳鼻咽喉头颈外科,成都610500

出　　处：《临床误诊误治》2020年第12期103-108,共6页Clinical Misdiagnosis & Mistherapy

基　　金：中国金属学会冶金安全与健康分会健康卫生科研项目(jkws201844)。

摘　　要：目的分析分泌性中耳炎(secretory otitis media,SOM)患者手术前后血清和中耳积液β2-微球蛋白(β2-M)、分泌型免疫球蛋白A(S-IgA)及炎性因子水平变化。方法选取88例行鼓膜切开置管术的SOM作为观察组,并选取同期入院体检健康者60例作为对照组。比较观察组术前血清和中耳积液与对照组体检时血清β2-M、S-IgA及炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]水平以及SOM患者术前及术后3 d血清和中耳积液β2-M、S-IgA及炎性因子水平,分析SOM患者血清和中耳积液β2-M、S-IgA与中耳积液炎性因子的相关性。结果与对照组血清比较,观察组术前血清和中耳积液β2-M、S-IgA、TNF-α、IL-6、IL-10水平升高,差异有统计学意义(P<0.05或P<0.01)。SOM患者术前和术后3 d血清β2-M、S-IgA、TNF-α、IL-6、IL-10水平均低于中耳积液水平,差异有统计学意义(P<0.01);与术前比较,SOM患者术后3 d血清和中耳积液β2-M、S-IgA、TNF-α、IL-6、IL-10水平下降,差异有统计学意义(P<0.01)。Pearson相关性分析显示,SOM患者血清β2-M、S-IgA与中耳积液TNF-α、IL-6呈正相关,中耳积液β2-M、S-IgA与中耳积液TNF-α、IL-6也呈正相关(P<0.05或P<0.01)。结论SOM患者手术前后血清及中耳积液β2-M、S-IgA和炎性因子均发生一定变化,可将上述因子作为SOM诊断与评估预后的辅助指标。Objective To analyze changes ofβ2 microglobulin(β2-M),secretory immunoglobulin A(S-IgA)and inflammatory factors in serum and middle ear effusion of patients with secretory otitis media(SOM)before and after surgery.Methods A total of 88 patients with SOM who underwent myringotomy with grommet insertion were selected as the observation group.Meanwhile,60 healthy physical examinees were selected as the control group.Levels ofβ2-M,S-IgA and inflammatory factors(TNF-α,IL-6,IL-10)in serum and middle ear effusion of the observation group before and after surgery as well as those in serum of the control group were compared.β2-M,S-IgA and inflammatory factors in SOM patients before surgery and at 3 d after operation were compared.Correlations betweenβ2-M,S-IgA and inflammatory factors in serum and middle ear effusion of SOM patients were analyzed.Results Before surgery,levels ofβ2-M,S-IgA,TNF-α,IL-6 and IL-10 in serum and middle ear effusion of the observation group were higher than those in the control group(P<0.05 or P<0.01).Serumβ2-M,S-IgA,TNF-α,IL-6 and IL-10 levels of SOM patients were lower than those in the middle ear effusion before and at 3 d after surgery(P<0.01).Compared with those before surgery,levels ofβ2-M,S-IgA,TNF-α,IL-6 and IL-10 of SOM patients were decreased at 3 d after surgery(P<0.01).Pearson correlation analysis showed that serumβ2-M and S-IgA were positively correlated with TNF-αand IL-6 in middle ear effusion in patients with SOM,andβ2-M and S-IgA in middle ear effusion were positively correlated with TNF-αand IL-6 in middle ear effusion(P<0.05 or P<0.01).Conclusion There are certain changes inβ2-M,S-IgA and inflammatory factors in serum and middle ear effusion of patients with SOM before and after surgery.The above factors can be used for auxiliary diagnosis and prognosis evaluation of SOM.

关 键 词：中耳炎 分泌性 Β2-微球蛋白 免疫球蛋白A 分泌 肿瘤坏死因子-α 白细胞介素-6 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]