目的探究分泌性中耳炎(otitis media with effusion,OME)患者中耳积液糖酵解代谢物乳酸的变化、与炎症指标水平的关系及机制。方法选取2022年8月至2024年8月河南大学郑州颐和医院收治的OME患者130例为研究组,另选取同期本院非感染性积...目的探究分泌性中耳炎(otitis media with effusion,OME)患者中耳积液糖酵解代谢物乳酸的变化、与炎症指标水平的关系及机制。方法选取2022年8月至2024年8月河南大学郑州颐和医院收治的OME患者130例为研究组,另选取同期本院非感染性积液患者130例为对照组,分析两组患者的中耳积液糖酵解代谢物乳酸和炎症因子的差异性及乳酸水平与炎症因子水平的相关性,分析年龄、性别、积液性质对乳酸、炎症因子的潜在影响。同时,通过细胞实验分析低乳酸组(1 mmol/L)、高乳酸组(5 mmol/L)和无乳酸组的中耳上皮细胞炎症反应差异性。结果研究组患者的乳酸水平、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)均高于对照组患者,差异具有统计学意义(P<0.05)。两组患者乳酸水平与TNF-α、IL-1β均呈显著正相关(r=0.958、0.967,P<0.001);TNF-α与IL-1β呈显著正相关(r=0.965,P<0.001)。协方差分析显示不同年龄组间乳酸和TNF-α平均水平存在显著差异。患者乳酸平均值在≤40岁组为2.3 mmol/L,>40岁组显著升高为3.1 mmol/L,差异具有统计学意义(P=0.013)。TNF-α水平在≤40岁组为85.2 ng/mL,>40岁组升高至102.6 ng/mL,差异具有统计学意义(P=0.006)。细胞实验结果显示,高浓度乳酸组TNF-α、IL-1β的mRNA水平、蛋白水平均高于低浓度乳酸组;低浓度乳酸组TNF-α、IL-1β的mRNA水平、蛋白水平均高于对照组,差异具有统计学意义(P<0.05)。结论乳酸作为糖酵解代谢的产物在OME发病中扮演重要角色,与炎症指标表达水平相关。高浓度乳酸环境会激发炎性指标的表达,提示乳酸可能具有作为OME潜在治疗靶点的价值。展开更多
Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secr...Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secretory otitis media admitted to our hospital from June 2024 to June 2025 were selected and randomly divided into two groups by drawing lots.The control group(42 cases)was treated with the traditional single-puncture tympanic membrane puncture and tympanic cavity drug injection method,while the observation group(42 cases)was treated with the double-puncture tympanic membrane puncture and tympanic cavity drug injection method.The therapeutic effects of the two groups were compared.Results:The overall treatment response rate,overall complication rate,time to symptom relief,and improvement in hearing threshold in the observation group were all superior to those in the control group,with statistically significant differences(P<0.05).Conclusion:For acute secretory otitis media,the treatment method of double-puncture tympanic membrane puncture and tympanic cavity drug injection demonstrates definite efficacy,significantly reducing the incidence of complications,accelerating symptom relief,and improving hearing function,making it worthy of promotion.展开更多
目的探究腺样体肥大(adenoid hypertrophy,AH)合并分泌性中耳炎(otitis media with effusion,OME)患儿术后复发的影响因素,并构建列线图风险预测模型。方法选取2019-01/2023-04月收治的476例AH合并OME患儿作为研究对象,依据7:3的比例随...目的探究腺样体肥大(adenoid hypertrophy,AH)合并分泌性中耳炎(otitis media with effusion,OME)患儿术后复发的影响因素,并构建列线图风险预测模型。方法选取2019-01/2023-04月收治的476例AH合并OME患儿作为研究对象,依据7:3的比例随机将患儿分为研究组(n=333)及验证组(n=143),依据术后1年的复发情况将研究组患者细分为复发组(n=62)及未复发组(n=271)。收集患者资料,采用多因素Logistic回归分析探讨AH合并OME术后复发的影响因素,采用R软件构建AH合并OME术后复发的列线图风险预测模型,采用受试者工作特征(receiver operating characteristic,ROC)曲线及霍斯默-莱梅肖(Hosmer-Lemeshow,H-L)拟合检验分析构建的风险预测模型的预测效能。结果复发组小于6岁、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度为Ⅲ~Ⅳ度患儿占比高于未复发组(P均<0.05);Logistic回归分析结果显示,年龄、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度是AH合并OME术后复发的影响因素(P<0.05)。H-L拟合检验显示构建的列线图风险预测模型的具有较好的一致性(P>0.05)。结论年龄、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度是AH合并OME术后复发的影响因素,由此构建的列线图风险预测模型具有较好的一致性及区分度。展开更多
文摘Objective:To explore the therapeutic effect of double-puncture tympanic membrane puncture and tympanic cavity drug injection in patients with acute secretory otitis media.Methods:A total of 84 patients with acute secretory otitis media admitted to our hospital from June 2024 to June 2025 were selected and randomly divided into two groups by drawing lots.The control group(42 cases)was treated with the traditional single-puncture tympanic membrane puncture and tympanic cavity drug injection method,while the observation group(42 cases)was treated with the double-puncture tympanic membrane puncture and tympanic cavity drug injection method.The therapeutic effects of the two groups were compared.Results:The overall treatment response rate,overall complication rate,time to symptom relief,and improvement in hearing threshold in the observation group were all superior to those in the control group,with statistically significant differences(P<0.05).Conclusion:For acute secretory otitis media,the treatment method of double-puncture tympanic membrane puncture and tympanic cavity drug injection demonstrates definite efficacy,significantly reducing the incidence of complications,accelerating symptom relief,and improving hearing function,making it worthy of promotion.
文摘目的探究腺样体肥大(adenoid hypertrophy,AH)合并分泌性中耳炎(otitis media with effusion,OME)患儿术后复发的影响因素,并构建列线图风险预测模型。方法选取2019-01/2023-04月收治的476例AH合并OME患儿作为研究对象,依据7:3的比例随机将患儿分为研究组(n=333)及验证组(n=143),依据术后1年的复发情况将研究组患者细分为复发组(n=62)及未复发组(n=271)。收集患者资料,采用多因素Logistic回归分析探讨AH合并OME术后复发的影响因素,采用R软件构建AH合并OME术后复发的列线图风险预测模型,采用受试者工作特征(receiver operating characteristic,ROC)曲线及霍斯默-莱梅肖(Hosmer-Lemeshow,H-L)拟合检验分析构建的风险预测模型的预测效能。结果复发组小于6岁、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度为Ⅲ~Ⅳ度患儿占比高于未复发组(P均<0.05);Logistic回归分析结果显示,年龄、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度是AH合并OME术后复发的影响因素(P<0.05)。H-L拟合检验显示构建的列线图风险预测模型的具有较好的一致性(P>0.05)。结论年龄、过敏性鼻炎、腭裂、伴反复呼吸道感染、乳突气化不良、腺样体肥大程度是AH合并OME术后复发的影响因素,由此构建的列线图风险预测模型具有较好的一致性及区分度。
