内毒素含量与分泌性中耳炎复发关系的研究

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402±22.24EU/ml)明显高于大于15岁组SOM患者(分别为18.9%和23±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±23.32EU/ml)高于浆液性积液的SOM患者(分别为21.1%和37±11.35EU/ml)，P值均<0.05。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<0.05)，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。

Relationship between endotoxin content and the recurrence of secretory otitis media

Objective　To study the relationship between endotoxin content and the recurrence of secretory otitis media (SOM).Methods　The endotoxin content of 88 middle ear effusion from 66 patients with SOM was investigated with the Limulus assay technique at different stages. Results　Both the positive rate and the concentration of endotoxin in SOM patients younger than 14 years, 77.2% and 402±22.24EU/ml, were higher than those in patients older than 15 years, 18.9% and 23±5.98EU/ml respectively; Both the positive rate and the concentration of endotoxin in SOM patients with mucoid middle ear effusion (MEE), 68.1% and 387±23.32EU/ml respectively, were also higher than those of SOM patients with serous MEE, 21.1% and 37±11.35EU/ml respectively (P<0.05 in all. Fifty-one ears of 88 ears with SOM experienced recurrence after the treatment by myringopuncture. The endotoxin content in MEE from the recurrence group was significantly higher than that from the cured group (P<0.05).Conclusion　Endotoxin might play an important role in the pathological course of SOM, especially in the persistence or recurrence of SOM in children with mucoid MEE.