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目的 :探讨分泌性中耳炎 (SOM )中耳积液中内毒素 (ET)、白细胞介素 1β(IL 1β)、正常T细胞表达和分泌、活化时调节的趋化因子 (RANTES)的表达以及它们在SOM发病中的作用。方法 :对 5 3例 72耳SOM患者行鼓膜穿刺 ,获得的中耳积液标本行细菌培养 ,然后采用鲎试验动态浊度法、放射免疫法以及双夹心抗体酶联免疫吸附法检测中耳积液中ET、IL 1β和RANTES的浓度。 结果 :①中耳积液中ET、IL 1β和RANTES阳性率分别为 80 .9%、77.8%和 70 .8% ,平均浓度为 (35 .2± 5 1.6 )EU/ml,(1.10± 0 .84 ) μg/L ,(0 .5 2± 0 .4 3) μg/L。②三者在黏液性积液中的含量高于浆液组 (P <0 .0 5 ) ;病程长者 ,ET、RANTES浓度也较高 (P <0 .0 5 ) ;细菌培养阳性中耳积液中三者的浓度亦明显高于细菌培养为阴性的积液 (P <0 .0 1)。③积液中ET含量与IL 1β呈显著正相关性 (r =0 .74 ,P <0 .0 1) ,IL 1β与RANTES之间也呈显著正相关 (r =0 .4 8,P <0 .0 1)。结论 :ET、IL 1β与RANTES参与了SOM发病的免疫机制 ,与鼓室内炎症反应的迁延 ,促使积液类型转化有关
Objective: To investigate the expression and secretion of endotoxin (ET), interleukin 1β (IL 1β) and normal T cells in middle ear effusion of secretory otitis media (SOM), the expression of chemotactic factor (RANTES) Role in the pathogenesis of SOM. Methods: Fifty-three patients with SOM of 72 ears underwent tympanic membrane puncture, and the middle ear effusion specimens were obtained by bacterial culture. Then the test of turbidity, radioimmunoassay and double antibody sandwich enzyme-linked immunosorbent assay Concentrations of ET, IL 1β and RANTES in fluids. Results: ① The positive rates of ET, IL 1β and RANTES in middle ear fluid were 80.9%, 77.8% and 70.8% respectively, with the average concentration of (35.2 ± 5.16) EU / ml and (1.10 ± 0 .84) μg / L, (0.52 ± 0.43) μg / L. ② The content of three in mucinous effusion was higher than that in the serous group (P <0.05). The older the course of disease, the higher the concentration of ET and RANTES (P <0.05) The concentration of the three fluids was also significantly higher than that of bacterial culture negative (P <0.01). (3) There was a significant positive correlation between the content of ET in effusion and IL 1β (r = 0.74, P <0.01), and the positive correlation between IL 1β and RANTES (r = 0.48, P < 0 .0 1). Conclusion: ET, IL 1β and RANTES are involved in the pathogenesis of SOM, which is related to the prolongation of inflammation in the tympanic cavity and the promotion of effusion type transformation