分泌性中耳炎衣原体感染血清学及Toll样受体相关mRNA表达  

Serological characteristics of otitis media with effusion patients with Chlamydia infection and expressions of Toll-like receptors-related mRNA

作　　者：孔德杰[1] 张智风[2] 闻克银[1] 张志德 陈海岩[1] 王晓宇[1] KONG De-jie;ZHANG Zhi-feng;WEN Ke-yin;ZHANG Zhi-de;CHEN Hai-yan;WANG Xiao-yu(Nanyang Second General Hospital,Nanyang,Henan 473000,China;不详)

机构地区：[1]南阳市第二人民医院耳鼻喉科,河南南阳473000 [2]郑州市第三人民医院耳鼻喉科,河南郑州450000

出　　处：《中华医院感染学杂志》2023年第13期2023-2027,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(LHGJ20191035)。

摘　　要：目的探究分泌性中耳炎(OME)衣原体感染血清学及Toll样受体(TLR)相关mRNA表达。方法选取2018年2月-2021年2月南阳市第二人民医院收治的OME患者126例为研究组,根据临床特征将研究组患者分为急性组31例、亚急性组42例和慢性组53例,另随机选取同期医院接受体检的健康体检者105名为对照组。采用微量免疫荧光法检测血清及中耳积液肺炎衣原体(Cp)、沙眼衣原体(Ct)和免疫球蛋白M(IgM)抗体;采用酶联免疫吸附法检测白细胞介素(IL)-1β、IL-8、IL-10和肿瘤坏死因子-α(TNF-α)水平;采用实时荧光定量聚合酶链反应法检测TLR2、TLR4 mRNA表达量。结果研究组各亚组血清及中耳积液Ct阳性检出率比较:急性组>亚急性组>慢性组(P<0.05),各亚组血清及中耳积液Cp阳性检出率比较,无统计学差异。各组血清IL-1β、IL-8、IL-10水平比较:对照组<急性组<亚急性组<慢性组(P<0.05)。各组TLR2、TLR4 mRNA表达量比较:对照组<急性组<亚急性组<慢性组(P<0.05)。结论衣原体是OME的重要致病微生物,Ct感染与OME病程关系密切;OME患者的炎症因子水平异常升高,并与OME的发生发展密切相关,其机制可能与TLR相关mRNA表达上调有关。OBJECTIVE To explore the serological characteristics of otitis media with effusion(OME)patients with Chlamydia infection and analyze the expressions of Toll-like receptors-related mRNA.METHODS A total of 126 patients with OME who were treated in Nanyang Second General Hospital from Feb 2018 to Feb 2021 were assigned as the study group and were divided into the acute group with 31 cases,the subacute group with 42 cases and the chronic group with 53 cases according to clinical characteristics.Meanwhile,105 people who received physical examination were chosen as the control group.The Chlamydia pneumoniae(Cp),Chlamydia trachomatis(Ct)and immunoglobulin M(IgM)antibodies in serum and middle ear effusion specimens were detected by microimmunofluorescence assay.The levels of interleukin(IL)-1β,IL-8,IL-10 and tumor necrosis factor-α(TNF-α)were detected by means of enzyme-linked immunosorbent assay(ELISA).The expression levels of TLR2 and TLR4 mRNA were detected by real-time fluorescent quantitative polymerase chain reaction.RESULTS The positive rate of Ct in serum and middle ear effusion specimens,from high to low,was in order as the following:the acute group,the subacute group,the chronic group(P<0.05);there was no significant difference in the positive rate of Cp in serum and middle ear effusion specimens among the subgroups.The levels of serum IL-1β,IL-8 and IL-10,from high to low,were as the following:the control group,the acute group,the subacute group,the chronic group(P<0.05).The expression levels of TLR2 and TLR4 mRNA,from high to low,were as the following:the control group,the acute group,the subacute group,the chronic group(P<O.05).CONCLUSION Chlamydia is a major microorganism to lead to OME,and Ct infection is closely associated with the course of OME.The patients with OME show abnormal rise of inflammatory factors,which is closely associated with the occurrence and development of OME;the mechanisms may be associated with the upregulated expressions of TLR-related mRNA.

关 键 词：分泌性中耳炎 肺炎衣原体 沙眼衣原体 感染 炎症因子 Toll样受体mRNA 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]