摘要
目的分析分泌性中耳炎(SOM)患儿外周血淋巴细胞及血清细胞因子的表达及激素干预的效果。方法选取90例SOM患儿作为病例组,选取30例健康儿童作为对照组,将病例组患儿随机分为A组(单纯口服抗生素治疗)、B组(口服抗生素联合局部激素治疗)和C组(口服抗生素联合全身激素治疗)各30例。比较病例组和对照组儿童的外周血CD_4^+T淋巴细胞比例、CD_8^+T淋巴细胞比例和CD_4^+/CD_8^+T淋巴细胞比值及血清白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)、肿瘤坏死因素-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平,比较A、B、C组患儿治疗后不同频率下气导听阈情况。结果病例组患儿的外周血CD_4^+T淋巴细胞比例、CD_4^+/CD_8^+T淋巴细胞比值和血清IL-2、IFN-γ、TNF-α、IL-6、IL-10水平均显著高于对照组(P<0.05)。治疗后,A、B、C组患儿的上述指标均下降,其中B组和C组与治疗前比较有显著差异(P<0.05)。B组或C组患儿在各同频率下气导听阈均显著低于A组患儿(P<0.05),而B组与C组患儿在各同频率下气导听阈的差异均无统计学意义(P>0.05)。结论 SOM患儿表现为外周血细胞免疫功能和细胞因子表达的失衡,在常规抗生素疗法的基础上加用激素治疗能够有效改善免疫功能指标,提高治疗效果。
Objective To analyze the expressions of lymphocytes in the peripheral blood and serum cytokines in the children with secretory otitis media(SOM)and the effects of glucocorticoids interventions.Methods Totally 90 SOM children were selected as case group,and 30 healthy children were selected as control group.The case group was randomly divided into group A(simple oral antibiotic treatment),group B(oral antibiotics combined with local glucocorticoid treatment)and group C(oral antibiotics combined with systemic glucocorticoid treatment),30 cases in each group.The CD 4+T lymphocytes percentage,CD 8+T lymphocytes percentage,the ratio of CD 4+/CD 8+T lymphocytes in peripheral blood and the serum interleukin-2(IL-2),interferon gamma(IFN-γ),tumor necrosis factor alpha(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10)levels were detected and compared between case group and control group.The air conduction auditory thresholds under different frequency of the patients in group A,group B and group C were examined and compared.Results The CD 4+T lymphocytes percentage,the ratio of CD 4+/CD 8+T lymphocytes in peripheral blood and the serum IL-2,IFN-γ,TNF-α,IL-6,IL-10 levels of the patients inthe case group were significantly higher than those in the control group(P<0.05).After the treatment,the above indicators of the children in group A,group B and group C decreased,and there were significant differences before and after the treatment between two groups(P<0.05).The air conduction auditory thresholds under different frequency of the patients in group B or group C were significantly lower than those in group A(P<0.05),while there were no significant differences in the air conduction auditory thresholds under different frequency between the children in group B and group C(P>0.05).Conclusion The patients with SOM show imbalanced cell immune function and cytokines expressions in the peripheral blood.The combination of glucocorticoids therapy and routine antibiotic therapy can effectively improve the immune function and the therapeutic effects.
作者
冯勇军
王明婧
吕梦颖
邓启华
吴湘明
曾春荣
吴智明
FENG Yongjun;WANG Mingjing;LYU Mengying;DENG Qihua;WU Xiangming;ZENG Chunrong;WU Zhiming(Department of Otorhinolaryngology Head and Neck Surgery,The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan,570311;Department of Laboratory,The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan,570311)
出处
《实用临床医药杂志》
CAS
2018年第3期51-55,共5页
Journal of Clinical Medicine in Practice
基金
海南省自然科学基金面上项目(20168292)
关键词
分泌性中耳炎
儿童
外周血
淋巴细胞亚群
细胞因子
激素治疗
secretory otitis media
children
peripheral blood
lymphocyte subgroups
cytokines
glucocorticoids therapy
