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目的 探讨中耳积液中的内毒素含量与分泌性中耳炎 (SOM)复发的关系。方法 用鲎珠溶解物凝胶反应法对 66名SOM患者共 88份中耳积液进行内毒素含量的动态检测。结果 内毒素检测阳性率和浓度在小于 14岁组的SOM患者 (分别为 77.2 %和 4 0 2±2 2 .2 4EU/ml)明显高于大于 15岁组SOM患者 (分别为 18.9%和 2 3± 5.98EU/ml) ;粘液性积液的SOM患者的内毒素检测阳性率和浓度 (分别为 68.1%和 387± 2 3.32EU/ml)高于浆液性积液的SOM患者 (分别为 2 1.1%和 37± 11.35EU/ml) ,P 值均 <0 .0 5。 88耳SOM经鼓膜穿刺治疗后 51耳复发 ,复发组的内毒素含量明显高于痊愈组 (P <0 .0 5) ,且第 2次复发的SOM患者的内毒素含量更高。结论 内毒素在SOM ,特别是在复发性SOM和儿童粘液型SOM病程中起重要作用。
Objective To investigate the relationship between endotoxin in effusion of middle ear and the recurrence of secretory otitis media (SOM). Methods A total of 88 samples of middle ear effusion of 66 patients with SOM were assayed for the dynamic endotoxin content by beads gel dissolution method. Results The positive rate and concentration of endotoxin in SOM patients younger than 14 years old (77.2% and 42.02 ± 2.24EU / ml, respectively) were significantly higher than those in SOM patients older than 15 years (18.9% and 2 3 ± 5.98EU / ml). The positive rate and concentration of endotoxin in SOM patients with mucinous effusion (68.1% and 387 ± 2 3.32EU / ml, respectively) were higher than that of SOM patients with serous effusion (2 1.1% and 37 ± 11.35EU / ml respectively), all P <0.05. The 88 cases of SOM had recurrence in 51 ears after tympanic membrane puncture. The endotoxin level in recurrence group was significantly higher than that in recovery group (P <0.05), and the endotoxin content in SOM with second recurrence was higher. Conclusion Endotoxin plays an important role in SOM, especially in the pathogenesis of recurrent SOM and childhood mucinous SOM.