新型冠状病毒感染后分泌性中耳炎临床特点分析  

Clinical Characteristics of Otitis Media with Effusion after COVID-19

作　　者：王磊[1] 韩浩伦[1] 王刚[1,2] 孙剑雄 李保卫 周莹 张艺俨[1] 孙喆喆 孙和方 吴玮 WANG Lei;HAN Haolun;WANG Gang;SUN Jianxiong;LI Baowei;ZHOU Ying;ZHANG Yiyan;SUN Zhezhe;SUN Hefang;WU Wei(Department of Otolaryngology,Ninth Medical Center of the Chinese PLA General Hospital,Beijing 100101,China;不详)

机构地区：[1]中国人民解放军总医院第九医学中心耳鼻咽喉科,北京100101 [2]国家环境保护环境感官应激与健康重点实验室 [3]中国人民解放军军事航天部队63710部队医院

出　　处：《中华耳科学杂志》2024年第5期780-784,共5页Chinese Journal of Otology

摘　　要：目的分析新型冠状(新冠)病毒感染后分泌性中耳炎(otitis media with effusion,OME)发病情况及临床特点。方法回顾性选取2018年12月至2019年1月、2021年12月至2022年1月、2022年12月至2023年1月中国人民解放军总医院第九医学中心耳鼻喉科门诊就诊患者21454例,其中OME患者201例。根据北京地区疫情流行及政府管控政策(公共场所佩戴口罩、减少聚集、居家隔离、疫苗接种等)时间,将201例OME患者分为疫情前组68例(2018年12月至2019年1月)、防控期组30例(2021年12月至2022年1月)、爆发期组103例(2022年12月至2023年1月)。收集201例OME患者资料,分析新冠病毒感染相关OME人口学特征及发病特点。结果防控期组OME就诊率(0.40%)较疫情前组(0.82%)显著下降,爆发期组(1.82%)较疫情前组、防控期组升高了51.5%与243.3%,差异均有统计学意义(P<0.01)。爆发期组92.2%的OME是新冠病毒感染之后出现的,较疫情前组、防控期组上呼吸道感染导致OME在中耳炎患者中的比例升高,差异均有统计学意义(P<0.01)。爆发期组上呼吸道感染导致OME患者年龄高于疫情前组和防控期组,差异有统计学意义(P<0.01,P=0.002)。74.6%的患者在新冠病毒感染之后的1~3周发病,7.5%的患者(5/67)在感染1月后才出现耳部症状。50.7%的患者仅有耳部症状且电子鼻咽喉镜检查仅31.3%合并鼻、鼻咽部轻微炎症。结论新冠病毒感染可明显提高OME发病率,老年人患病率更高。新冠相关OME往往在感染后2周甚至更晚出现。新冠病毒有可能通过直接感染中耳引发炎症,具体机制有待进一步研究。Objective To report incidence and clinical characteristics of otitis media with effusion(OME)after coronavirus infection disease 2019(COVID-19).Methods Patients with OME(n=201)were retrospectively identified among 21,454 patients visiting the department of otorhinolaryngology of the Ninth Medical Center,the PLA General Hospital,from December 2018 to January 2019,December 2021 to January 2022,and December 2022 to January 2023.According to the epidemic situation and government control policies in Beijing(mask wearing in public places,reducing gatherings,home isolation,vaccination,etc.),the 201 patients were divided into a pre-pandemic group(between 1/12/2018 and 31/01/2019,n=68),a prevention and containment period group(between 1/12/2021 and 31/01/2022,n=30),and an outbreak period group(between 1/12/2022 and 31/01/2023,n=103).Data analyzed included demographic characteristics and morbidity of OME related to COVID-19.Results The rate of OME in the prevention and containment period(0.40%)was significantly lower than in the pre-pandemic group(0.82%).The rate of OME in the outbreak-period(1.82%)rose by 51.5%and 243.3%compared to the pre-pandemic and prevention and containment periods(P<0.01).In the outbreak-period group,92.2%of OME occurred immediately following COVID-19 infection,higher than in the pre-pandemic and prevention and containment periods(P﹤0.01).Patients with COVID-19 related OME were elder than those with non-COVID-19 related OME(P<0.01).Among patients with COVID-19 related OME,74.6%had hearing problems and/or ear fullness within 1~3 weeks after COVID-19 that lasted longer than 1 month in 7.5%of them.Of these patients,50.7%had only ear symptoms and 31.3%showed signs of mild inflammation in the nose and nasopharynx on laryngoscopy.Conclusion COVID-19 infection can significantly increase the incidence of OME,with higher prevalence among elder people.COVID-19 related OME often appears 2 weeks or later after the infection.COVID-19 may cause OME by infecting the middle ear directly,and the specific mechanism

关 键 词：分泌性中耳炎 新型冠状病毒感染 呼吸道感染 

分 类 号：R511[医药卫生—内科学] R764.21[医药卫生—临床医学]