Abstract:

Objective　To investigate the changes of nitric oxide (NO) and inflammatory factors in the ear effusion in patients with secretory otitis media. Methods　Ninety patients with secretory otitis media admitted to Joint Support Force 908 Hospital from January 2022 to April 2023 were selected as an observation group, and 90 healthy individuals during the same period were selected as a control group. In the observation group, there were 54 males and 36 females, aged (39.18±3.19) years, 58 cases in mucous stage and 32 cases in serous stage, 38 cases in acute stage and 52 cases in chronic stage. In the control group, there were 50 males and 40 females, aged (40.53±4.21) years. The levels of NO, γ-interferon (IFN-γ), and interleukin-2 (IL-2) in the ear effusion and levels of immunoglobulin (Ig) and peripheral blood T lymphocyte subsets were compared. Independent sample t test and χ² test were used for statistical analysis. Results　The levels of IgM, IgG, and IgA in the observation group were higher than those in the control group (all P<0.001). The levels of CD4/CD8, CD4⁺, and CD3⁺ in peripheral blood T lymphocyte subsets were lower than those in the control group, and the level of CD8⁺ was higher than that in the control group (all P<0.001). The levels of IL-2, IFN-γ, NO, IgM, IgG, IgA, CD4/CD8, CD8⁺, CD4⁺, and CD3⁺ in the acute stage patients were (10.79±1.43) mg/L, (75.42±18.67) µg/L, (2.69±0.49) mg/L, (3.81±0.36) g/L, (19.92±2.28) g/L, (3.81±0.33) g/L, (1.59±0.24), (23.40±3.42)%, (42.31±4.23)%, and (61.38±5.17)%, those in the chronic stage patients were (13.35±1.48) mg/L, (108.72±21.34) µg/L, (4.38±0.58) mg/L, (5.41±0.38) g/L, (33.46±2.53) g/L, (4.96±0.41) g/L, (1.32±0.15), (34.23±3.62)%, (38.11±0.04)%, and (55.30±4.94)%, with statistically significant differences (t=8.221, 7.701, 14.557, 20.169, 26.130, 14.239, 6.554, 14.346, 7.175, and 5.655; all P<0.001). The levels of IL-2, IFN-γ, NO, IgM, IgG, IgA, CD4/CD8, CD8+, CD4+, and CD3+ in the mucous stage patients were (15.62±1.65) mg/L, (111.73±22.14) µg/L, (5.08±0.63) mg/L, (34.18±2.49) g/L, (5.13±0.42) g/L, (1.34±0.18) g/L, (1.30±0.14), (35.61±3.59)%, (37.52±4.12)%, and (56.48±4.52)%, those in the serous stage patients were (9.90±1.39) mg/L, (70.42±17.80) µg/L, (2.67±0.52) mg/L, (3.87±0.32) g/L, (20.41±2.35) g/L, (3.93±0.34) g/L, (1.72±0.23), (25.63±3.54)%, (41.92±4.24)%, (60.82±5.24)%, with statistically significant differences (t=16.615, 9.056, 18.438, 68.378, 48.349, 47.347, 10.775, 12.686, 4.800, and 4.118; all P<0.001). Conclusion　For patients with secretory otitis media, the degree of disease can be comprehensively understood by the indicators of immune status and IL-2, IFN-γ, and NO in the ear effusion, with high clinical application value.

Key words:

Secretory otitis media, Ear effusion, NO, inflammatory factors

摘要：

目的　探讨分泌性中耳炎患者耳积液中一氧化氮（NO）及炎性因子指标变化。方法　选取中国人民解放军联勤保障部队第九〇八医院2022年1月至2023年4月收治的90例分泌性中耳炎患者为观察组，选择同期的90例健康人员作为对照组行队列研究。观察组男54例，女36例，年龄（39.18±3.19）岁；其中黏液期58例、浆液期32例，急性期38例、慢性期52例。对照组男50例，女40例，年龄（40.53±4.21）岁。对比耳积液中NO、γ-干扰素（IFN-γ）、白细胞介素-2（IL-2）水平，以及免疫球蛋白（Ig）、外周血T淋巴细胞亚群水平。统计学方法使用独立样本t检验、χ²检验。结果　观察组IgM、IgG、IgA水平均高于对照组（均P<0.001）；外周血T淋巴细胞亚群中的CD4/CD8、CD4⁺、CD3⁺水平均低于对照组，CD8⁺水平高于对照组（均P<0.001）。急性期患者的IL-2、IFN-γ、NO、IgM、IgG、IgA、CD4/CD8、CD8⁺、CD4⁺、CD3⁺水平分别为（10.79±1.43）mg/L、（75.42±18.67）µg/L、（2.69±0.49）mg/L、（3.81±0.36）g/L、（19.92±2.28）g/L、（3.81±0.33）g/L、（1.59±0.24）、（23.40±3.42）%、（42.31±4.23）%、（61.38±5.17）%，慢性期患者分别为（13.35±1.48）mg/L、（108.72±21.34）µg/L、（4.38±0.58）mg/L、（5.41±0.38）g/L、（33.46±2.53）g/L、（4.96±0.41）g/L、（1.32±0.15）、（34.23±3.62）%、（38.11±0.04）%、（55.30±4.94）%，差异均有统计学意义（t=8.221、7.701、14.557、20.169、26.130、14.239、6.554、14.346、7.175、5.655，均P<0.001）。黏液期患者的IL-2、IFN-γ、NO、IgM、IgG、IgA、CD4/CD8、CD8⁺、CD4⁺、CD3⁺水平分别为（15.62±1.65）mg/L、（111.73±22.14）µg/L、（5.08±0.63）mg/L、（34.18±2.49）g/L、（5.13±0.42）g/L、（1.34±0.18）g/L、（1.30±0.14）、（35.61±3.59）%、（37.52±4.12）%、（56.48±4.52）%；浆液期患者分别为（9.90±1.39）mg/L、（70.42±17.80）µg/L、（2.67±0.52）mg/L、（3.87±0.32）g/L、（20.41±2.35）g/L、（3.93±0.34）g/L、（1.72±0.23）、（25.63±3.54）%、（41.92±4.24）%、（60.82±5.24）%，差异均有统计学意义（t=16.615、9.056、18.438、68.378、48.349、47.347、10.775、12.686、4.800、4.118，均P<0.001）。结论　针对分泌性中耳炎患者，可通过免疫状态及耳积液IL-2、IFN-γ、NO等指标全面了解患者疾病程度，具有较高的临床应用价值。

关键词:

分泌性中耳炎, 耳积液, 一氧化氮, 炎性因子