腺样体肥大儿童伴变应性鼻炎与分泌性中耳炎的相关性分析

目的分析腺样体肥大儿童伴分泌性中耳炎（OME）与变应性鼻炎（AR）发病的相关性。方法回顾性分析12岁以下870例腺样体肥大患儿的病史，分析AR、咽鼓管功能不良及OME的相关性。结果本组腺样体肥大患儿中AR发病率为30．11％，AR在不同年龄组中的发病率差异有统计学意义，随着年龄增加，发病率逐渐升高（P〈0．01）。6岁以内发生咽鼓管功能障碍及OME的概率高，其中1～3岁组发生分泌性中耳炎的概率最大（P〈0．01）。春季OME发病率高（P〈0．001）。与不伴AR患者相比，伴有AR患儿患咽鼓管功能不良的概率增加了0．4倍（P=0．042）；但患有OME的检出率减少了32％（P=0．0472）。结论在腺样体肥大患儿中，多种因素使咽鼓管功能不良乃至OME高发。其中咽鼓管及其周围结构生理、病理、发育特点是最主要的因素，变态反应是次要影响因素。随着年龄增长，前者因逐渐发育完善，致病性降低，后者致病性增高，但总的发病率是逐渐降低的。

Relationship between allergic rhinitis and secretory otitis media in children with adenoid hypertrophy.

Objective To investigate the correlation between otitis media with effusion （OME） and allergic rhinitis （AR） in children with adenoid hypertrophy. Methods 870 patients under 12 years old with adenoid hypertrophy were collected for current retrospective analysis. Association between AR and eustachian tube dysfunction and OME was cal- culated by Chi-square test and logistic regression model. Results The prevalence of allergic rhinitis children with ade- noid hypertrophy was 30.11%. The prevalence of allergic rhinitis in different age groups had significant difference and increased with age（ P 〈 0.01 ）. The probability of eustachian tube dysfunction and OME occurring in patients younger than 6 years was high and reached the highest in 1 to 3 years old patients（P =0.001 ）. OME prevalence was higher in spring（P =0. 001 ） than in other seasons. The prevalence of allergic rhinitis with eustachian tube dysfunction was 1.4 times higher than those without allergic rhinitis （P --0. 042 ）. The detection rate of OME with AR was 0.32 times hihger than that of OME without AR（ P = 0. 052）. Conclusion The structures, physiological and pathological characteristics of eustachian tube are the main factors causing eustachian tube dysfunction and high incidence of OME. Allergy maybe the secondary factor. With children＇s growth, the pathogenicity of the former becomes lower and the latter becomes higher, but the incidence of otitis media with effusion decreases.