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[目的]探讨胃食管反流病与分泌性中耳炎的关系及临床意义。[方法]选择2010年6月~2015年1月来我院就诊的70例胃食管反流病(GERD)合并分泌性中耳炎患者为研究对象,作为观察组;另选择同期在本院治疗的50例分泌性中耳炎患者为对照组。2组患者均检测pH值、胆汁酸,并进行24h食管pH监测,记录酸反流次数、反流≥5min次数、pH<4的时间并进行比较;检测2组患者鼓室积液中胃蛋白酶含量、表达阳性率并进行比较。[结果]GERD组的pH值明显小于对照组(P<0.05),GERD组的胆汁酸含量明显高于对照组(P<0.05);GERD组鼓室积液中胃蛋白酶水平显著高于对照组(P<0.05),GERD组胃蛋白酶阳性表达率38.57%显著高于对照组4.00%(χ2=19.022,P<0.05);GERD组患者治疗后酸反流次数、反流≥5min次数、pH<4的时间均比治疗前显著性降低(P<0.05),GERD组患者治疗后鼓室积液中胃蛋白酶水平显著低于治疗前水平(P<0.05),GERD组患者治疗后胃蛋白酶阳性表达率为22.86%显著低于治疗前38.57%(χ2=4.0614,P<0.05)。[结论]GERD与分泌性中耳炎的发病机制可能有关,胃十二指肠中的内容物可能因反流进入鼻咽、鼓室内,引发分泌性中耳炎,提示通过治疗GERD可能改善分泌性中耳炎。
[Objective] To investigate the relationship between gastroesophageal reflux disease and secretory otitis media and its clinical significance. [Methods] Seventy patients with gastroesophageal reflux disease (GERD) and secretory otitis media who came to our hospital from June 2010 to January 2015 were selected as the observation group. Another 50 patients treated in our hospital Cases of secretory otitis media for the control group. The pH value and bile acid were detected in both groups, and the esophageal pH was monitored for 24 hours. The number of acid reflux, reflux times ≥5 minutes, pH <4 were recorded and compared. The content of pepsin in tympanic effusion , The positive rate of expression and comparison. [Result] The pH value of GERD group was significantly lower than that of control group (P <0.05), and the bile acid content of GERD group was significantly higher than that of control group (P <0.05). The pepsin level of GERD group was significantly higher than that of control group P <0.05). The positive expression rate of pepsin in GERD group was 38.57%, which was significantly higher than that in control group (χ2 = 19.022, P <0.05). The number of acid reflux, (P <0.05). The level of pepsin in tympanic effusion of GERD group was significantly lower than that before treatment (P <0.05), and the positive expression rate of pepsin in GERD group was 22.86% was significantly lower than 38.57% before treatment (χ2 = 4.0614, P <0.05). [Conclusion] The pathogenesis of secretory otitis media may be related to GERD. The content of gastroduodenal may enter into the nasopharynx and tympanic cavity by reflux, causing secretory otitis media, suggesting that the treatment of GERD may improve the secretory otitis media.