放线菌在儿童扁桃体组织中的临床病理观察  

Clinicopathological observation of actinomycetes in tonsil tissue of children

作　　者：朱增辉 周鹏 李轩毅 刘稳 ZHU Zenghui;ZHOU Peng;LI Xuanyi;LIU Wen(Department of Otorhinolarygngology,Affiliated Hospital of Xuzhou Medical University,Xuzhou221006,China)

机构地区：[1]徐州医科大学附属医院耳鼻咽喉科,江苏徐州221006

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第2期78-81,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：江苏省中医药科技发展计划项目(QN202009);徐州市重点研发计划(社会发展)(KC20067)。

摘　　要：目的观察放线菌在儿童扁桃体组织中的分布,探讨儿童慢性扁桃体炎病原体的多样性。方法回顾性分析2019年1月—2020年12月因慢性扁桃体炎或扁桃体肥大施行手术的儿童223例,根据病史分成两组,其中A组128例,B组95例。按照不同年龄段组(2~4岁、5~7岁、≥8岁)进行亚组分析,观察比较两组扁桃体病理切片中放线菌团块存在情况。结果观察到放线菌团块的阳性病例47例(21.9%),其中A组37例(28.9%),B组10例(10.5%),两组差异具有统计学意义(P<0.05)。发现不同年龄组中放线菌团阳性数随年龄增长而增多,≥8岁年龄组中放线菌团块的阳性率达25例(36.8%),总体呈正相关趋势(r s=0.249,P<0.05),这种正相关趋势主要体现在A组患儿中(r s=0.278,P<0.05),B组病例不同年龄组中放线菌团阳性率无显著差异(P>0.05)。结论放线菌在慢性扁桃体炎患儿的扁桃体组织中较为常见,而且其阳性率随着年龄的增长而升高,临床诊疗中抗生素选择上应考虑针对放线菌的药物。Objective To observe the distribution of actinomycetes in tonsil tissue of children and explore the diversity of pathogens in children’s chronic tonsillitis. Methods A retrospective analysis was performed on 223 children who underwent tonsillectomy for chronic tonsillitis or tonsillar hypertrophy in our hospital from Dec 2019 to Jan 2020. According to the medical history, all the cases were divided into two groups: group A(n=128) and group B(n=95), and the presence of actinomycetic clumps in tonsil specimens of the two groups was observed and compared. Results There were 47 positive cases(21.9%) of actinomycetes clumps, including 37 cases in group A(28.9%) and 10 cases in group B(10.5%), and the difference of positive rate between the two groups was statistically significant(P>0.05). Stratified analysis was conducted according to different age groups of 2~4 years, 5~7 years, and ≥8 years. It was found that the positive rate of actinomycetes increased with age. The positive rate of actinomycetes in ≥8 years age group was up to 36.8%, showing a positive correlation with age(r;=0.249, P<0.05). This positive correlation mainly existed in group A(r;=0.278, P<0.05), while the differences of positive rate among different age subgroups in group B were statistically insignificant(P>0.05). Conclusions Actinomycetes are common in the tonsil tissue removed from children with chronic tonsillitis and the positive rate increases with age. Drugs targeting actinomycosis should be considered in the selection of antibiotics in clinical treatment.

关 键 词：慢性扁桃体炎 放线菌感染 儿童扁桃体肥大 组织病理学 

分 类 号：R766.18[医药卫生—耳鼻咽喉科]